“Shruti has been with me for almost 2 years now, and it has been a great journey, especially during the COVID pandemic. She has been an invaluable asset in providing continued care to people at home, especially in the limited resources and restrictions in mobility precluding exercise. Shruti has consulted almost 500 patients online during the pandemic and has helped people with medications and nutrition and insulin techniques, dose adjustment of insulin and emotional/psychological support. She has guided close to 100 women through their pregnancy as well during this time.
She is bright, cheerful and brilliant, effortlessly adjusting to the situation and client in front of her, eager to learn and grow. She is great at motivating people to take baby steps to a healthier life.”
As an Endocrinologist, knowing the current lifestyle of the person is of paramount importance. The person’s daily schedule, the time they wake up, the time they sleep, when they take their meals, whether eating home-cooked or outside food, greatly impact how to help the person with their health.
In our practice, we prefer that our clients speak to our nutritionist first and then see the doctor. It is invaluable to the doctor to have the context of the patient to personalize the treatment best. Often, we avoid medication completely if we feel the person has many possible modifications in their lifestyle, which may suffice for their condition (e.g., newly diagnosed Diabetes Mellitus or Gestational Diabetes/ pregnancy-induced diabetes, PCOS). We can also get away with minimal change in medications by making small changes in a person’s lifestyle (time of dinner, smaller meal portion).
About Pratiksha Palkar:
- Pratiksha Palkar has done her Msc in Clinical Nutrition and Dietetics from SNDT university, Mumbai. She is a Certified Diabetes Educator having completed a 1 year course under the aegis of the National Diabetes Educator Program.
About Nilam Ghadge:
Dietician Shruti is awesome with her craft. She provides the patients with profound knowledge to deal with their respective ailments. She gives a perfect insight into overcoming the problems/lifestyle disease easily. Scientific standards back the best part of her inputs.
She explains the diet plan; exercise regimen elaborately. The Do’s and Don’ts are explained methodically. Above all, her patience is highly appreciated. She is a perfect blend of a Dietitian who is a thorough professional still never ceases to give her Personal Midas touch. She helped me with my Thyroid and Hormonal problems.
We are married for the last six years and tried to conceive from last three years. Meanwhile, I have known that I am suffering from PCOS. In such a case, my weight also gains rapidly. I have tried all treatment, exercise (Gym / Zumba), but it is hard to reverse my PCOS and reduce weight. Meanwhile, I have consulted with Dietitian Shruti madam. After following their diet plan with good nutrition value, I have reduced 6+ kg weight and conceive naturally.
Shruti has made my life easy by giving me details of food to eat and its intake level in my daily routine. She is just too good in her delivery of conversation, especially with older people. Her detail diet plan has made my life easy. I would recommend her to my other friends and colleagues, as she is highly approachable.
My Dietitian “Shruti Doshi” is amazing at her job, and she truly cares about her clients. When I was doing terribly with my stress eating and diabetes, she cared enough to follow up with my doctor. I don’t know what things would be like today if she hadn’t done that, but I can’t thank her enough! She has helped me so much in developing habits and routines that help me to stay on track. I came some time ago for a few nutrition counselling sessions as my blood sugar levels were slightly high. I am happy to report that they are now in control without medication in less than three months. She helped me through it, and dieting was never tough with her help. I enjoy my sessions with my dietitian a lot and appreciate her knowledge and the help she gave me to look at things more healthily.
My blood glucose levels were usually high. My knowledge about food choices was limited. I used to take a large varying range of insulin doses. Eating healthy is very important in keeping blood sugars within the target range. Knowing well about diet, exercise & medication constitutes to your diabetes management. Shruti ma’am made things very simple. She taught me carb-counting and helped me create a meal plan. I started making healthy eating choices. I learnt how carbs, proteins & fats affect blood glucose(BG). I started to keep a food diary(what, when & how much I eat). Shruti ma’am gave me a meal plan based on my weight, physical activities, type of diabetes, medication & food preferences. Now, I can see how food & insulin is affecting my BG levels. The largely varying insulin doses are now mostly fixed units, and BG levels are well within the target range.
I am an engineering student, making it difficult for me to maintain my weight due to exam pressure and stress. Before taking Dr Shruti’s diet, I was unable to lose my weight even after exercising regularly. But, as soon as we consulted her, she provided us with a diet chart on the same day and believed that we could see the effect in 1 week after following it. According to our routine, she made the diet chart, so it was custom and not fixed for everyone that helped me a lot to follow it in my busy routine. I had minor PCOS, which makes it difficult for me to lose weight. But her diet plan helped me overcome PCOS and lose weight, and now after following the diet plan for two months, I have lost 7 kgs.
Within one month, I could get my hbA1c down by 1 point, and Shruti’s diet plan was easy to follow. Things were not forced upon me. With your diet plan, I feel much lighter. I don’t know how much weight I lost, but I feel fresh n energetic and the knowledge you have given about carb counting that was best and very helpful. You have made me self-dependent. Now all I have to do is to timely visit you, and also you were always available whenever I needed expert advice.
1st time consult with detailed lifestyle assessment and exact diet plan.
The dietician will go through the patient’s medical condition and assess the lifestyle of the patient.
After analyzing, a realistic goal would be set together, and a balanced diet would be planned depending upon the patient’s requirement, eating habits daily routine and lifestyle.
Follow up for two weeks with 6 personalized diet plans + exercise schedule.
Follow up two weekly + 12 personalized diet plan + free monthly follow up to 1 yr + exercising schedule.
Our perception of our weight is often erroneous. Underweight is defined as Body Mass index less than 18 kg/m2, so first please check whether you are underweight or not (BMI = Weight / Height in meter squared)( https://www.calculator.net/bmi-calculator.html) I would also like to clarify that at the same BMI, Asian Indians have more fat than their Western counterpart which is the reason we have a greater risk of PCOS and diabetes at lower body weight. These are important concepts to understand before deciding whether you need to lose weight or not.
If you have a BMI Less than 18, we would suggest a balanced diet to help fat loss but retain muscle mass (weight unchanged) to have better health at the same weight. A diet high in protein, high in fibre and moderate in carbohydrates under the guidance of a trained nutritionist will help you achieve this.
We all want to know about that one magical diet or that one superfood which will cause quick weight loss. However, when you lose weight with a fad/ crash diet too quickly, you lose muscle rather than fat. It is not feasible to follow a crash/extreme diet in the long term. It can also lead to many negative eating behaviours like binge eating, night eating and yo-yo eating.
In PCOS, more than weight loss alone, body composition namely body fat is more important as it is the culprit which causes the hormonal imbalance. Gradual calorie and carbohydrate reduction with an increase in protein and fibre intake are key. Keep doing moderate-intensity exercise simultaneously (cycling/walking/swimming/jogging) for 30 minutes at least five days a week. Work with a trained nutritionist to achieve your goals.
Keep a target that is achievable but realistic – approx. 0.5 kgs per week = 2 kgs / month. Focus on inch loss as that will ensure you are using fat and not muscle. Remember that PCOS makes it harder for you to lose weight – be kind to yourself. It is hard, but not impossible. Weight maintenance is as important as weight loss.
This is not true. If you are taking your medications properly and your report is normal, you can certainly achieve weight loss. It would help if you had a comprehensive evaluation of your current lifestyle and eating pattern and a customized/personalized plan to suit your tastes and choices to lose weight with the help of a trained nutritionist. You can do it!
The problem with skipping meals is that it leads to hunger pangs and cravings at a later time. Usually, when we are very hungry, we tend to make the wrong choices and often eat more than what we skipped and often make unhealthy choices. It is better to eat healthy food at regular times in small portions.
Your visible fat consumption (oil/ghee/dalda) may be low but invisible fats (non-veg foods/full cream milk&products) may be high. Also, high intake of refined cereals-maida based foods, bakery foods like biscuits, bread, sweets, chocolates and alcohol can cause your TGs to elevate. Kindly consult your nutritionist regarding the alternatives for it.
Fruits are a source of fibre along with important vitamins and minerals. During the preparation of fruit juices, the fruit after blending is strained. ON straining, the fibre is lost, which is the key factor that helps to lose weight also to maintain blood sugar levels. Also, there is a loss of certain vitamins when not consumed fresh. Hence, to enjoy all the benefits of fruits, it is best to have the whole (along with skin).
Yes, you can have them with the help of the leaching process. Connect with your nutritionist to she can guide you depending upon your blood parameters what exactly to do.
Recommendation for protein in people with kidney disease is usually 0.6-0.8 g/kg body weight. However, the Indian diet is usually quite low in proteins. See your nutritionist understand how much protein you are currently consuming and then decide if you need to cut down. People with kidney conditions already have low muscle mass, and protein is important for muscle repair and muscle mass. Your nutritionist can help you select the right kind of protein.
Yes, you can have sugar-free /artificial sweeteners as a substitute for sugar or jaggery. It does not have any side effect if taken in the appropriate quantity. However, it is important to understand the difference.
Base content (aspartame, sucralose) of each sweetener before you buy is recommended depending upon the medical condition. Your nutritionist can help you to select the right kind of sugar substitute.
Alcohol is a source of “empty calories” and causes an elevation in blood glucose levels. It is advisable to avoid alcohol as much as possible. However depending upon your blood reports, the nutritionist will recommend the frequency and amount of alcohol you can consume. What is often more important is what food is consumed with alcohol (fried snacks, peanuts), cut the oil and eat salads and boiled veggies.
Yes, if you have pre-diabetes ( Hba1c < 6.5%) or early diabetes ( less than four years, on medications alone), then weight loss of approx. 5-10% with good diet and exercise can help you manage your blood sugars well even without meds. Do let your doctor know so that they can help you keep track of your blood sugars.
Diet coke has empty calories (no fibre, vital vitamins or minerals) and sugar-free cakes have invisible fat, elevating your sugar levels and cholesterol levels. Kindly consult your nutritionist regarding the alternatives for it.
In celiac disease, we need to avoid food rich in wheat and its products. People often advised gluten-free diet to eat many simple carbohydrates like rice and rice-based dosas, idlis, and appams. Or they get fooled into eating “wheat-free biscuits and snacks.”
However, one can opt for other cereals like millets, jowar, bajra, and ragi, which will help in digestion and help manage the elevated sugar levels as they are a good source of fibre.
Instead of indulging indiscriminately and feeling guilty later, you can enjoy eating out by learning to eat right at family functions/parties/restaurants. You can opt for soup or salad at a party or restaurant to start with so that you can eat less of the main course. Stay hydrated. The main course, go for grilled/tandoor/roasted paneer/chicken or fish. Tandoori roti and Missi (besan) rotis are a better choice than Naan or puris. Skip dessert completely or if you must have it, go for fresh fruits. Also, sizzlers/stir fry vegetables/dal fry are better options than gravy-based dishes. Alcohol also has calories, so don’t forget to figure that in.
A sweet can be a fruit / any low-fat milk-based dessert with an artificial sweetener/ a few dates and not necessarily a mithai or chocolate. Do not stock chocolates or sweets at your place because you will be tempted to have it if it is available.
Find alternate ways to relieve stress like regular walks, meditation, keeping a journal, gardening, listening to music or reading a book. Take help from family and friends, discuss your problems with them rather than eating to relieve stress.
Importance of Nutrition In Endocrine Conditions:
Good nutrition is indispensable in managing all endocrine conditions, especially in Diabetes Mellitus, Thyroid Conditions such as Hypothyroid & Hyperthyroid, Obesity, & Polycystic Ovarian Disease(PCOS), where weight management greatly augments medical treatment.
Studies have shown that even 5-7% of weight loss can help reverse early Diabetes, and by maintaining weight, one can keep the condition at bay. Studies also suggest that proper nutrition helps to balance BP as well as elevated cholesterol levels. It is also seen under the nutritional guidance one can maintain high or abrupt Creatine Values and Electrolytes in Chronic Kidney Patients (CKD) patients.
Thyroid medication is weight dependent, and losing weight can help minimize the dose of the thyroid medications.
Weight loss can help regularize periods and help prevent the onset of diabetes in polycystic ovarian disease(PCOS)—a positive impact on body image and self-esteem.
Osteoporosis is a skeletal disease characterized by low bone mass and disrupted bone architecture, increasing bone brittleness and fracture risk. Diet of a large part of society is not properly balanced, which can cause abnormalities in achieving proper bone mineralization. Changes in the nutritional regimen are required already during childhood because nutritional mistakes are the main cause of diet-related diseases in adulthood.
One of the studies done is 2013. It states that one in three adults worldwide was overweight or obese. Adult obesity has exceeded 50%, and childhood obesity has exceeded 30%. The risk of Metabolic Disorders like Diabetes, PCOS, Elevated Lipid Profile, and Kidney Disorders have gone up. Hence it is always important to do lifestyle modification with proper guidance.