dimanche 22 avril 2018


I am an Endocrinologist, a physician specializing in the Metabolism of the body, about the balance of various hormones is of interest to me.
Very early on in my training, it was drilled into me that you do not give hormones to people who do not have low levels of that hormones: Testosterone, Thyroid to give two common examples. It was fashionable to give thyroid hormones for weight loss,  practice which had crept into oblivion. 
Supplement of the Day is FISH OIL, even recommended by the American Heart Association (I also do not pay much attention to what these mavens say, including the American Diabetes Association, as they all seem to be far away from the reality of the estranged people that I work with).
Vitamin of the day is Vitamin D. 
When it comes to Vitamins or Food Supplements I believe that one must obtain them in the most natural way as feasible. 20 minutes of sunshine would give you enough Vitamin D (a little longer if you are chubby? or dark skinned). Fish Oil is bountiful in fish and it is the best way to obtain the fish oil (some native people avoid fish not to break some traditional taboo).
RIP Fish Oil 
The new meta-analysis, published in JAMA Cardiology in January, looked at randomized trials of marine-derived omega-3 fatty acid supplements involving almost 78 000 participants with a history of coronary heart disease (66%), stroke (28%), or diabetes (37%). The trials lasted an average of 4.4 years and compared fish oil with placebo or no treatment in at least 500 participants.

All told, fish oil supplements did not reduce the risk of coronary heart disease deaths, nonfatal heart attacks, fatal or nonfatal strokes, revascularization procedures, or all-cause mortality among the full study population. The supplements also didn’t protect against major vascular events in any subgroups, including people with a history of heart disease, diabetes, high cholesterol, or statin use.
There is also a tendancy in the American mainstream and auxiliary health care scene that if a little bit is good, more is better. Metabolism does not work that way!  thus these megadoses of many ingredients sold to an unsuspecting public.
I work with poor people and despite the difficulties they face, they try to do what is natural, as they understand Nature and their role in it.

How do I get my vitamins and Fish Oil and Vitamin D?
a druze village near Haifa.

The New Israeli cuisine is delicious and very healthy, the best of the Mediterranean Nutrition.

 Eating in Miami with friends, Portuguese Sea Food 
 A little Nosh 
Marriott Marquis Lounge in Doha, Qatar
Shabbat Dinner in Israel 
The benefits of Red Wine are due to its RESERVATROL. They try to market it as pills, obviously it does not have the same effect. 
Eating food with friends has an incredible relaxing and socially beneficial effects.
 I eat very well in Havana, Cuba (thanks to neighbours who help)

 A visiting american Indian helped prepare a Lobster dinner
I love breaking bread with my Cuban friends and colleagues!


Between UmonHon Indians and an anticipated Asian meal at the KLCC in Kuala Lumpur, I wanted to feed my Spirits and who better to listen to than SADHGURU?
If you listen to his dietary advice, about frequency, types of food to eat, he is basing his knowledge on historic Yogic tradition.
The western mind asks for explanation, that is the logic. Faith is less relevant than scientific proof.
I have been advocating, longer periods of giving your metabolism a rest, completing your days nutrition within a 10 hour period. 
Here I am quoting from a scientific article published in the Proceedings of National Academy of Science in the USA 2014, I am not editorializing but quoting verbatim from their article. If you watch Sadhguru first and read the excerpts from the article second, you would see the connection between the Spirit and the Science.

Proc Natl Acad Sci U S A. 2014 Nov 25; 111(47): 16647–16653.
Meal frequency and timing in health and disease

The most common eating pattern in modern societies, three meals plus snacks every day, is abnormal from an evolutionary perspective. Emerging findings from studies of animal models and human subjects suggest that intermittent energy restriction periods of as little as 16 h can improve health indicators and counteract disease processes. The mechanisms involve a metabolic shift to fat metabolism and ketone production, and stimulation of adaptive cellular stress responses that prevent and repair molecular damage. 

Some of the advice provided by physicians and dieticians to their patients is consistent with the current scientific evidence, including the benefits of vegetables, fruits, fiber, nuts, and fish, and the value of reducing or eliminating snacks. However, there are many myths and presumptions concerning diet and health, including that it is important to eat three or more meals per day on a regular basis 

Unlike modern humans and domesticated animals, the eating patterns of many mammals are characterized by intermittent energy intake. Carnivores may kill and eat prey only a few times each week or even less frequently , and hunter-gatherer anthropoids, including those living today, often eat intermittently depending upon food availability . The ability to function at a high level, both physically and mentally, during extended periods without food may have been of fundamental importance in our evolutionary history.
A metabolic shift to ketogenesis that occurs with fasting bolsters neuronal bioenergetics. Liver glycogen stores are typically depleted within 10–12 h of fasting, which is followed by liberation of fatty acids from adipose tissue cells into the blood. The fatty acids are then transported into liver cells where they are oxidized to generate Acetyl-CoA. Acetyl-CoA is then converted to 3-hydroxy-3-methylgluaryl-CoA, which is in turn used to generate the ketones acetoacetate and β-hydroxybutyrate (β-OHB). The ketones are released into the blood and are transported into various tissues, including the brain, where they are taken up by neurons and used to produce acetyl-CoA. Acetyl-CoA enters the tricarboxylic acid (TCA) cycle to generate ATP. 
Obesity has also become a major health problem in dogs and cats, which are often fed ad libitum , and even laboratory rodents can often be considered overfed and sedentary . Indeed, animals in the wild and hunter-gatherer humans rarely, if ever, suffer from obesity, diabetes, and cardiovascular disease

Compared with those fed ad libitum, the lifespans of organisms from yeast and worms, to mice and monkeys can be extended by dietary energy restriction . Data collected from individuals practicing severe dietary restriction indicate that humans undergo many of the same molecular, metabolic, and physiologic adaptations typical of long-lived CR rodents . IER/fasting can forestall and even reverse disease processes in animal models of various cancers, cardiovascular disease, diabetes, and neurodegenerative disorders 

The high rates of childhood and adult obesity and the diseases they foster is a major burden to our society. As findings from basic research studies and controlled interventional trials accrue, consensus recommendations for healthy patterns of meal frequency and diurnal timing may eventually emerge. If sufficient evidence does emerge to support public health and clinical recommendations to alter meal patterning, there will be numerous forces at play in the acceptance or resistance to such recommendations. First and perhaps foremost is cultural tradition. Three meals plus snacks daily has become the norm during the past half-century, such that a majority of American children are accustomed to this eating pattern. Second, the agriculture, food processing, food retail, and restaurant industries and all of the affiliated industries that serve or promote food—from airlines to concert stadiums to television cooking shows to advertising and others—still all have established practices and financial interests and these interests may affect receptivity to proposed shifts in eating patterns and potential decreases in total food purchased. Third, the willingness and ability of the American health care system, including medical training and practice, to emphasize prevention and lifestyles will be a key factor in success or lack thereof.
The following slide is part of a presentation last week at the Nebraska Minority Health Initiative Annual Conference in Nebraska, USA


The pundits on this side of the Gulf pontificate about democracy in the island of Cuba, make grandiose pronouncements (remember, The Final Hour of Castro, a book published in the early 1990s? by a Miami based futurist?), release poiltical prisoners, have free elections and make everything possible to achieve that aim by denying the Cubans in the island to improve their lives. Since the ascendancy of Trump  the Historicos (ageing cuban immigrants and their mouthpieces like Marco Rubio) have done their best to squash any chance of improvement in the lives of an ordinary Cuban in the island.
Obama opened up Cuba and the effects were immediate. Hope was in the air, thousands of people began to exercise their entrepreneurial skills and the general economic situation began to get better. American tourists began to pour in, mainly to Havana and Havana began its new life of cafe, clubs, restaurants and meeting places, much more than what democracy would have provided. 
 More than one million americans poured in and those of us who spend time in Havana at last had chances to eat like those who live under "democracy mongers" as well!
Average Cubans now could rent out their homes. Air BnB reported that since that December when Obama opened the gates, the fastest growth in Air BnB anywhere in the world was in Cuba!
This is an example of a private apartment for rent in Veddo a stylish neighbourhood in Havana. The owner does not have any connection with Miami, nor did they receive any funds from USA to begin their business operations.
this very busy private restaurant along the Rampa was begun by a humble Cuban student on his return from Mexico, he called it La Burrito Habanero (pun intended) and is very successful with visiting American students.
Other small businesses, taking into consideration the sweet tooth of the Cubans were bakeries and cake makers who made a decent living by made to order cakes at home.
The American policies of Trump which seems to be hijacked by Marco Rubio and the Historicos (old cuban immigrants, their children do not always support their views). 
Who is suffering?
The average Cuban in the island
Small cafes like this that sell coffe and home made sweets and cakes and small sandwiches depended upon the foot traffic of the tourists (who then become regular visitors as they know a bargain when they see one)
(PS This cafe is owned by a friend of mine, and note the Israeli flag which he proudly displays, my gift  which I had bought in Haifa streets for 5 shekels)

So, please come and visit the Island. I see that the frequencies of flights to the island nor the ubiquitous Cruise ship itineraries have been affected by the Miami Gang.

Make sure you stay at an AirBnB and not a hotel
Make sure that you engage a private taxi and not a state one.
Visit one of the numerous private restaurants scattered around
Go outside of the tourist ghettos of Old Havana, Varadero Beach, Vinales and Trinidad


dimanche 15 avril 2018


HUMAN TOUCH  as a mystic, therapeutic and culturally relevant symbol, is receiving some scientific attention as well.
I have just left Cuba and one of the first things I note with nostalgia and a bit of sadness is that people don't touch each other in other countries 
In Cuba, a person who does not touch another would be considered an oddity and the children are taught to hug and kiss people from an early age . We kiss and hug each other when we enter the house of someone and when we leave, and also when we meet each other in public. This human warmth goes well with the Country's ethic about being a humane country.
So it was nice to hear the Indian mystic Sadhguru talk about the human touch. Here is a video from him.
Being an endocrinologist, I have long been interested in the abnormal elevations of hormones brought on by the increased pressures  put on individuals by the society. 
I had felt that both Obesity and Type 2 Diabetes are Social Illnesses in that the life as perceived by the individuals within the social structures they are in and sometimes  trapped in, can give rise to these diseases.
Can stress give rise to Diabetes Type 2? I would ask the American Indians gathered at some tribal clinic.
The answer would be a resounding YES
and they would add, we should know about the stress of living in this society.
Of course now the stress of living has extended not to just Indians living in the USA or the Aboriginal people living in Australia but to a broad spectrum of people living under different conditions all around the world.
The hormonal mediators of stress and its ill effects are well understood now, after scientists have worked out the mechanisms.
Stress can increase Cortisol
Cortisol can bring on Type 2 Diabetes
Cortisol can make people put on weight 
Cortisol can increase Blood Pressure

We should look for social solutions to damage caused by the society. Yoga and Meditation both are known to bring down cortisol levels so are laughter, prayer, friendship and sharing time with family. 
So I was happy to read this article which was sent to me by the Endocrine Society of Europe.

Gentle touch can decrease stress
April 3, 2018, Swedish Research Council

Credit: Swedish Research Council

Long lasting gentle touch decreases stress hormones and decelerate heart beat frequency. It also activates brain areas commonly linked to reward. These research results are presented in a new thesis from the University of Gothenburg. Findings that can be useful in designing therapies to help people relax.
gentle touch is comforting for most people, is perceived as pleasurable and alleviates stress. What actually produces this wellbeing, and what happens in the brain when the body is caressed gently, has been the focus for Chantal Triscoli's thesis. In a series of laboratory experiments, involving all in all 125 participants, she has studied the effects of touch using a brush on the forearm. She found that gentel touch not only was perceived as pleasant over a long time, but it also had a decreasing effect on stress hormones and a deceleration of heart beat.
"One hypothesis we had was that the body would become used to the touch, reaching satiety, and thus should the positive effects decrease over time. But what I found was the opposite," Chantal Triscoli says.
Chantal Triscoli conducts basic research, adding to the knowledge about how the healthy nervous system works. In one of the experiments, she could show how different parts of the brain, i.e. reward-related networks and networks for processing the discriminatory features of touch, are activated by brush stroking a person's forearm.
Though basic research, Chantal Triscoli's findings also can be useful in applied science, i.e. on a more clinical level.
"I can see that touch might be helpful in several types of therapy; for example in stress treatments and for helping people in anxiety states to relax," she says.
"And when treating illnesses it is first necessary to understand how a healthy brain works," she concludes.

Just because science lags behind millennial belief systems and their effects, we must not reject socially oriented therapies for illnesses caused by the society, which are among  the majority of the illnesses of the modern living.

Perhaps that is why the  American Indians, the last of the colonized people in the West (along with their Australian, Aotearoan and Kalahari cousins) as well as the Cuban people face their cotidian difficulties with such strength and give each other a hand that brings out the best of humanity in them.
When I am in Cuba, I am not only touched physically by my friends but also touched in many other forms, as explained in the following video by Sadhguru in replying to a question about touch by the famous Cardiothoracic surgeon  Dr Devi Shetty.


samedi 7 avril 2018


Anthony Bourdain from Parts Unknown, in giving advice to travellers, had explained why it is better to concentrate on a small place on each trip, rather than trying to see, accommodate and be stressed by a hectic travel itinerary.
Somewhere, you can walk and expect the usual and the unexpected.
To me, that place is Fort Cochin, not Kochi or Ernakulum but the ancient port of Cochin, conquered by the Portuguese in 1495, the Dutch in the 17th century and followed by the British where a polyglot population live in a reasonably tolerant environment.

(view from Bristow's Bistro)
It had taken me 48 hours to get from Miami to Cochin via the airports at Philadelphia, Doha and Colombo and I arrived at the Bristow Lighthouse Hotel facing the Arabian Sea, to a warm welcome. For the next four days and three nights, I did not venture more than one mile by foot from the hotel. All meals were had at the hotel specially prepared by chef Rehman Vipin and attentively served by his staff. The GM, Rajesh Rajan was always at hand to make sure that the stay at the hotel was the best of the see breeze ambiance it is famous for.
 (Breadfruit tree at the entrance of the Bristow Lighthouse Hotel)

It is a small boutique hotel, converted from the residence of Sir Robert Bristow, the man who created the Willingdon Island in the middle of backwaters as they meet the open ocean, which was considered an engineering feat in the 1930s.
A labour of Love, the owner VG was to tell me later.
Sir Robert’s house now has just 15 rooms of which 4 are outside, varying in size and shape.
The house/hotel faces the Arabian Sea, the only one such in all of Fort Cochin. The views of the Sun setting down the Arabian Sea are just gorgeous. There is always a breeze and open air Bristow’s Bistro which has no windows lets in ample breeze to compliment your meal prepared by Executive Chef Rehman Vipin.
Fort Cochin beach and the ever-popular promenade along the backwaters (as the backwaters and the sea become one) are just a few feet away, secluded but not excluded.

There is a parade ground where popular meetings had been held, such as the attempt by the Dutch in the early 1600s to blow up the St Francis Catholic Church. It is surrounded by excellent examples of colonial residential architecture-namely Dutch and English. It is a sheer delight to walk around the parade ground, admiring the various buildings, occasionally we can learn about the history of some of them, such as David Hall built by the Yemenite Jewish merchant Ezekiel Rahabi, next to it, the distinctively British Cochin Club which at one time was so segregated that they even refused membership to Sir Robert Bristow’s Eurasian wife! (Who went on to found the LOTUS club).
St Francis Church, Vasco House, pop in to post a card at the Post Office, talk to Tarik, the owner/manager of Farmers Café, a delightful addition to the upper end dining of Fort Cochin. The middle and lower end dining along the Princess Street, a hangout of backpackers, is shamelessly of poor quality. You very seldom see Indian or local tourists in Fort Cochin (outside of the beach hours), even though I have seen an odd one or two, but it is not common.
 (no wonder people come just to watch the waves at sunset or sunrise)

 (tablet commemorating 500 years of Portugese-Cochin contact)
 (at every corner something waits for you, from quaint churches to the Dutch Cemetery)

Vasco da Gama square has hundreds of little stalls selling everything you can imagine but usually of poor quality, a poor Xerox version of made in china goods. Shopping is best done on the other side of the bay; I cannot imagine anyone coming to Fort Cochin to shop. If you are unfortunate, you may be lured into one of the ubiquitous Kashmiri shops, which have proliferated like parasites that sell things that have no relationship to Cochin, these shops are really an eye sore I highly recommend that you avoid stores that call themselves Antique Emporiums and such and displaying goods which are not local, These cunning merchants will sell you low grade merchandise passing them as Pashmina, and the innocent tourist is out of pocket for a 100 dollars or so (the original costs of these “pashminas” are about 3 dollars each, good quality Pashminas are very expensive.)
But outside of these silly tourist shops the real local life buzzes all around you.

(I always search for this mother daughter tribal family who make bangles and ear rings which I take to other parts of the world to be given away as gifts)
I have visited Fort Cochin on numerous occasions, have become a familiar face, and am greeted as such by the local dwellers, in this small corner of Cochin.

More than one tuk-tuk driver invite me to share tea with them in their favourite hang out in Rose Street, many of the small stall holders greet warmly. The grumpy owner of the Elite café complain about the crowding of the Princess street, the Muslim owner of the store on the corner of Princess and Bastion streets flash a smile of betel stains with symbolisms of their recently acquired wealth.
The local people are generally friendly (apart from the Kashmiri touts and others trying to wean a rupee or two out of you) and would start a conversation with you. I have enjoyed very many good conversations on this small area of Fort Cochin so full of history.
I had flown 10 000 miles (16000 km) and stayed 4 days and 3 nights at Bristow Lighthouse hotel and day 4 went back to the airport to travel another 5000 miles to Paris (8000 km). During the time I had not left the one sq. km area.

I had been here before so nothing urgent was beckoning, except for the desire to have Ayurvedic massages on a daily basis
Raghavan from Andhra Pradesh and SriKanth from Trivandrum conspired with the Chef Rehman to provide three breakfasts and three dinners, highlighting the Kerala cuisine. They know that I did not travel those thousands of kilometres to eat pseudo European food. So each morning and evening it was a medley of Kerala/Cochini food at its best. I had brought a Radius Merlot 2016 (Washington State) with me; so as the Sun began its descent around 6 pm, I would pour myself a glass, stare at the colours of the western skies. A slow dinner would follow at 730-8 pm, ending up at 10-11 pm with a nice cup of milk coffee or tea.
Was I bored? Out of question
Did I meet some new people? Yes
Did I have any unique experiences? Yes
Nothing was planned and everything went smoothly, things happened as it was supposed to happen, managed by the Sprits, as the Indians would say.
Look, there are dolphins out in sea, someone having breakfast at a table nearby pointed out.

That is how I met Dra. C and Miss J, a mother and daughter travelling team with wonderful stories of their varied travels, The other is a specialist Obs-Gyanae physician with a developing interest in Gyanaecological oncology and the daughter is an aspiring medical student whose recent international medical adventure was as an Intern at a clinic in Galle, Sri Lanka. They both had been to an Ayurvedic resort near Trichur and were enjoying the delights of Fort Cochin. (The mother had been here before more than once)
It was obvious that travel is knitted well into the fibre of our beings. During the last dinner time, we talked late into the night, as the impatient waiters were waiting to set up the tables for breakfast which would begin in a few short hours.
Rarely do I meet visitors to the hotel that becomes momentarily our homes.  Most tourists fill their agendas with itineraries resembling their office agenda and do not have the time to wholeheartedly explore the local lives lived in the places they visit.
When I said good-bye to them on the morning of my departure, I had the distinct feeling that I would see them again-somewhere!
My square kilometer of Fort Cochin, the attention by Suresh, SriKanth and Raghavan and chef Rehman, supervised well by the General Manager, Rajesh
Then this wonderful conversation and exchange with the doctora and her daughter.

Did anything else happen n my stay in Fort Cochin, which seemed aimless in the beginning?
If I say mystical, my experience of meeting a remarkable man on the second night of dinner, would not explain the scope of that encounter
The words of my Meskwakia teacher echoed in my ears: Stop searching for people, those who you need to meet will come across your path.
He and his wife, residents of Bombay, invited me to their dinner table and immediately I felt that I was in the presence of a special man! (A man who possesses the third eye, GM told me later). Instead of the natter about the What and How of our lives, we got into the why of our lives. I told him of my encounter in Madras in January 2009 with a blind astrologer and how he wanted me to find two women living in two different countries other than the one where I grew up, but were with me the first 30 months of my life.
A bond was created between me and VG and his wife S, we delved deeper, and his wife excused herself to attend to their two boys. Even though I have been involved in Humanitarian medicine all my professional life, I never recount the difficulties faced by me to bring health/disease care to the poor in some of the poorest countries in the world. The GM brought him my date and place of birth from the hotel registry (from copies of my passport he keeps). He was doing some calculations on his smartphone and he began asking me some questions about certain important events in my life, without my ever telling him. I told him of the world of spirits and symbolism that the American Indians are surrounded by. I told him of my various journeys to offer help to the indigenous peoples in remote parts of the world: Kalahari desert to be with San people, along the Amazon River to meet with the Tikuna, to Rapa Nui to understand the struggles of the native Easter Islanders.
I had a chance to say a prayer for him (connected to the American Indians, thanking my little brother Mauricio of the Omaha for his presence) and I was amazed at the power and effect of the sincerity of prayer (thanks to the Spirits)
This also meant I had a chance to talk openly to him, like no one else before him in India. My father’s work in Burma (I identify with Burma very strongly, told him my Burmese name, Aung Khant), my complete transformation in Australia (I consider myself an Australian, grateful for what that country has done for me, but now Cuba occupies the last physical space in my heart)
He had an insight into my life, I felt I had known for a while and considered him a good friend (two others in India comes close, both from Cochin, RN and MM)
It was already time to say good-bye and a day later I received this email from him.

It was wonderful meeting you. You have been an astounding account of dejavu wherein you feel you know the individual for many lifetimes. I truly enjoyed the time spent and your life is an inspiration for humility, selfless giving and the art of happiness. I wish and pray for your all round health, happiness and prosperity in all its forms gaja lakshmi.

I encircle you with my aura of love and protection. Please stay in our house next time in Mumbai. S and myself welcome you with open arms.

That is what happened to me
On this unplanned trip to Fort Cochin
10 000 miles away, and when I got there
I never went further than 1 km from the hotel
Bristow Lighthouse Hotel

I felt so grateful
So in the ambiance of the Spirits
So satisfied with my sacrifices for the drop of humanitarian work that I do

7 April 2018
I am preparing to leave tomorrow to where my heart is
The City of Havana
The Island of Cuba

Special thanks to Mr Rajesh Rajan the GM at Old Lighthouse Bristow Bungalow Heritage Hotel