The Truth about Coconut Water

Food, Lifestyle

Benefits of drinking coconut

We are all familiar with the uses of the coconut fruit from coconut water to other derived ingredients like coconut oil and coconut milk. Coconut water being the latest health food fad.

From unmarketable by-product to the most popular drink

Traditionally, coconuts were harvested for their meat or white coconut kernel to extract coconut oil. Because fresh coconut water is quick to decompose once the coconut is cut, the water was often discarded as an unmarketable by-product. With developments in technology, coconut water is now being preserved in cans or tetra packs and exported to international markets.

Coconut water- Why so Popular?

Fresh coconut (Cocos nucifera L) water is a clear, sterile, colourless and naturally flavoured drink.

Its main constituents (depending on fruit maturity levels) are:

  • Water- H2O
  • Sodium- Na
  • Potassium- K
  • Chlorine- Cl
  • Sulphur- S
  • Calcium- Ca
  • Magnesium- Mg
  • Phosphorus- P
  • Manganese- Mn
  • Aluminium- Al
  • Zinc- Zn
  • Iron- Fe
  • Copper- Cu

Other traces of elements such as selenium, boron, molybdenum are also found. All of these minerals are in the form of electrolytes, which means it can be easily absorbed by the human body.

It is also a rich source of essential amino acids (lysine, histidine, tyrosine, L-arginine and tryptophan), fatty acids, glucose, fructose, cellulose, sucrose, and organic acids such as tartaric, citric and malic acids. The contents in the coconut water is similar to the body fluid plasma. In WWII, coconut water was used as intravenous fluid hydration and also as resuscitation fluid. In other words, coconut water was infused directly into the veins to improve the fluid balance in the body. Most of the health benefits attributed to coconut water can be traced to its amazingly rich mineral content.

Lets look at the health benefits of coconut water

  • Low-fat Low-sugar drink

Compared to other readily available soda drinks that are high in chemicals (artificial colour and flavouring agents), fat and sugar, coconut water is relatively low in fat and sugar. It contains only a fifth of the sugar that you get from an equal amount of fresh grape or apple juice. Even though it has a low sugar content, it has a mildly sweet and delicate flavour. Making it a healthier alternative to most retail drinks.

  • Prevent heat stroke

heat stroke and coconut

Dehydration and heat stroke is very common in hot weather. It has been shown that coconut water is better than normal water and even fruit juices when it comes to such conditions. This is because, coconut water  re-hydrates the body by providing essential minerals that correct the electrolyte balance in the body.

  • Nature’s sports drink

The natural electrolyte content in coconut water is better than the chemical electrolyte additives in the commercial sports drinks. The potassium content in coconut water will help you get rid of any muscle cramps and replenish the nutrients that your body has lost during a moderate workout.

sports drinks

  • Treatment for severe dehydration

Layout 2

Coconut water’s unique mineral composition is able to rehydrate the body and give it the necessary nutrients to recover. In addition, coconut water has a rich enzyme system which has been used in the treatment of diarrhoea, stomach flu as well as urinary stone dissolution.

  • Good heart, nerve and muscle functioning

Our body has the inherent ability to provide the nutrient supply for the functioning of various body parts. Coconut water has a rich content of potassium and some amount of sodium that plays a role in the normal bodily function.

Sodium K pump

Sodium is the principal ion in the fluid outside of cells while potassium is the principal ion in the fluid inside of cells. The concentration differences between potassium and sodium across cell membranes create an electrochemical difference known as the membrane potential. The membrane potential is the basis for any cell function. A large portion of energy in the body is focused at maintaining sodium/potassium concentration gradients and tight control of this cell membrane potential is critical for heart function, nerve impulse transmission and muscle contraction.

  • Controls Blood pressure (BP) and prevents heart disease

Doctor taking patient's blood pressure

High potassium content in coconut water can cause vasodilation in blood vessels and a significant improvement in endothelial cell (cells of the arteries wall) function. The walls of the arteries get dilated and improves blood flow. This will not only help reduce high BP but will also prevent any chances of atherosclerosis (Heart disease in which plaque develops in the arteries of the heart causing hardening and lack of blood flow).

  • Anti-aging effect

Coconut water contains a rich source of cytokinins which is a growth-regulating hormone. This aids in repairing cell damage and degeneration.

  • Treatment of Kidney Stones

Coconut water also helps to dissolve kidney stones by alkalizing the urine and acting as a natural diuretic. This means that drinking coconut water will increase urine production and flow.  Dilute alkaline urine has a lesser chance for crystal formation since most minerals get dissolved completely in alkaline urine.

  • Antioxidant effect

Amino acid L-arginine present in coconut water significantly reduces free radical damage. It reduces the oxidative damage to cells of our body, slowing down the aging process.

  • Hormonal effect

Coconut juice is also believed to contain phytoestrogen and other sex hormone-like substances which can be used in hormone replacement therapy. This can reduce the risk of dementia and aid wound healing in postmenopausal women.

Given its wide range of benefits, this drink has gained a huge following and widespread availability. While coconut water has its goodness, it’s always wise to have a balanced diet and consume all foods in moderation. When in doubt, always seek an expert for advice.

Anatomy of the Hip

anatomy, Hip, Lifestyle

hip joint

The anatomy of the hip includes the ball-and-socket joint that involve two separate bones namely, the thigh bone and the pelvis.The unique anatomy of the hip enables it to be extremely strong and agile controlling every position of the lower limb in both weight-bearing and non-weight-bearing movements.

Bones of the Hip 

The Bones of the Hip include,

  • Pelvic bones (Ilium, Ischium, Pubis)
  • Femur (Thigh bone)

Fig 1: Shows the two Hip bones, sacrum, the acetabular socket of the hip joint, the entire Hip.


As shown in Fig.1, the pelvis is made up of two halves or two hip bones. Each hip bone is formed from the fusion of three bones: ilium, ischium and pubis. Fusion of these three bones, form one solid pelvic bone. The Pelvic bone contributes to the hip socket or acetabulum. Each pubic bone connect in front at the symphysis pubis.

Between the two hip bones, lies the foundation for the pelvis, the sacrum. The sacrum is a triangular-shaped bone that comprise of five fused bones at the lower end of the spine.

Fig 2. The Femur (thigh bone)


As shown in fig 2, the femur is more commonly known as the thigh bone which consists of the round head, the neck, the shaft and two condyles (lateral and medial) at the base of the femur.

The HIP joint

Like the shoulder, the hip joint is also a ball-and-socket joint, where the ball is the head of the femur, and the socket is the acetabulum.

Fig 3: Ball and socket hip joint


Articular Cartilage and labrum

The articular cartilage is a protective material that covers the articular surfaces of the hip joint (refer Fig.4).  It is about one-quarter of an inch in thickness with a rubbery consistency.The function of the cartilage is related to its structure and thus acts as a shock absorber by allowing better transmission of forces. It also helps prevent friction between the bones and is slippery enough to allow the joint surfaces to slide against one another without causing any damage.

The Labrum is a fibrous rim of cartilage around the acetabular socket that holds the femoral head in the joint providing stability.

Fig 4: Shows articular cartilage and labrum

cartilage and labrum

Joint capsule and ligaments of the Hip joint

The joint capsule is a watertight sac that surrounds the hip joint. The capsule is reinforced by three major ligaments, which are denser bands of connective tissue.

Fig 5: Shows Capsule and reinforced ligaments of the hip joint

capsule and lig

The attachments of each of these ligaments can be identified by its name- the iliofemoral ligament extends from the ilium on the pelvis to the femur, the pubofemoral ligament connects the pubic bone to the femur, and the ischiofemoral ligament extends from the ischium to the femur.

A small ligament called ligamentum teres connects the very tip of the femoral head to the acetabular socket. It accommodates a small artery within itself that brings an important blood supply to part of the femoral head.

Muscles around the hip joint:

Back muscles of the hip 

These Muscles are responsible for hip joint extension (backward movement)

They include,

  • Gluteus maximus
  • Hamstrings (long head of biceps femoris, semitendinosus, semimembranosus)

Fig 6: Extensor muscles

gluteal and hamstring muscles

These muscles cause the hip to move backwards in extension (Fig 7), it also causes knee flexion (bending the knee by bringing the heel towards the buttock). Hip extension is important during gait especially to propel your body forwards.

Fig 7: Hip extension movement of the hip joint

hip extention

Gluteus maximus contraction is a powerful action that opposes the force of gravity. The action of gluteus maximus is to move the hip bone(thigh) backward from a position of full flexion(bent), as in climbing stairs, or rising from a squatting or sitting position.

Fig 8: Action of Gluteus Maximus muscle

Gluteus max sit to stand

Front muscles of the pelvis

These muscles are responsible for hip joint flexion (forward movement).They include,

  • Iliopsoas (iliacus and psoas)
  • Rectus femoris
  • Tensor fasciae latae
  • Sartorius

Fig 9: Hip Flexor muscles

fllexor muscles

The hip flexors help you to draw your leg towards your chest and also helps to you move your legs from side to side and backwards. It serves to stabilize your hips, keeping the joints of your pelvis and lower back strong.

Fig 10: Hip flexion movement

hip flexion

Hip flexion movement is also important during the gait cycle in order to bring you leg forwards for heel strike.

Inner thigh muscles

These muscles are responsible for hip joint adduction (inward movement).They include,

  • Pectineus
  • Adductor brevis
  • Adductor longus
  • Gracilis
  • Adductor magnus.

Fig11: Aductor muscles of the hip joint

hip adductors

When the foot is not planted on the ground, the adductors will bring the leg toward the midline of the body. Also known as an open kinetic chain movement (open kinetic chain is defined as a combination of successively arranged joints in which the terminal body segment can move freely).

Fig 12: Adduction movement


Apart from the adduction movement in open kinetic chain, adductors also contributes during closed kinetic chain movements (In a closed kinetic chain movement, the distal end of the extremity is fixed, emphasizing joint compression and, in turn, stabilizing the joints).

A simple example would be during bilateral stance (standing on both legs) movement like squatting, adductors of both the hip joints help contribute to the stability in the pelvis. These adductors work with abductor muscles synergistically to provide side-to-side stabilization of the pelvis.

During walking, adductors also contribute throughout the gait cycle. For example, when you foot is move forwards before striking on the ground, the adductors will bring the leg towards the midline. Similarily, adductors with help in flexing the hip when the thigh is in an extended position as in the swing phase of the gait (walking) cycle.

Fig 13: Action of adductors during gait

Gait cycle

They are not the prime movers but function in reflex response to gait activities.

The only two-joint muscle of the adductor group, the gracilis, functions as an inner knee stabilizer and helps stabilize both the hip and knee during weight-bearing.

Outer muscles of the thigh

These muscles are responsible for hip joint abduction (outward movement). They include,

  • Gluteus medius
  • Gluteus minimus
  • Tensor fascia latae

Fig 14: Abductor muscles of the hip


In open kinetic chain movement when standing on one leg, the abductors move the leg away from the midline of the body.

Fig 15: Abduction in single leg stance

hip abduction

The gluteus medius however, is more of a lower extremity dynamic stabilizer than it is a pure hip abductor.  If the gluteus medius and minimus are weak or atrophied, the pelvis will drop to the opposite side when you bear full weight on the same side during walking. This dysfunctional postural pattern is referred to as the Trendelenburg sign.

Fig 16: Pelvic stabilization (strong Gluteus medius) and pelvic drop (weak Gluteus medius)

Gluteus medius

As you can see in fig 16, weakness of the right gluteus medius will cause the left hip to drop when standing on the right leg. Thus, during walking the primary function of the gluteus medius is to stabilize the pelvis when weight is shifted from one side to the other.

External rotators of the hip joint

Muscles of the thigh responsible for hip joint external rotation (twisting hip outwards) include,

Primary External Rotators:

  • Obturatorius internus and externus
  • Gemellus superior and inferior
  • Quadratus femoris
  • Piriformis

Secondary External Rotators:

  • Gluteus Maximus (lower fibres)
  • Gluteus Medius and minimus muscles when the hip is extended
  • Psoas Major Muscle
  • Psoas Minor Muscle
  • Sartorius

In the open kinetic chain the primary and secondary external rotators turn the lower limb outwards in relation to a fixed pelvis. This action is seen with the movement of the hip with knee flexion as seen in Fig 17.

Fig 17: External rotation


However, in the closed kinetic chain scenario, with the foot fixed on the ground, the activation of these same muscles will cause the same movement at the hip-pelvis interface will cause the pelvis/torso to rotate.  For example, refer Fig 18. a closed chain right lower limb, upon activation of the external hip rotators the person’s pelvis and trunk will rotate to the left simultaneously (counterclockwise rotation) along the vertical body axis about the fixed right limb.

Fig.18 external rotation of right hip

Standing twist

This rotation can occur from activation of not only the hip rotators but also from the muscles of the abdomen, thoracic spine and rib cage.

Role in Hip stabilization

The deep external rotators (quadratus femoris, obturator internus and externus and the gemelli) are also active stabilisers of the hip and, along with the internally rotator gluteus minimis, they are also described as the “rotator cuff muscles” of the hip. The quadratus femoris,

During weight bearing, the deep rotators having a short moment arm and smaller in area there is minimal capacity of rotational force and more of  a horizontal line of force, which is more important in the compression of the joint surfaces.Thus creating more stability in the hip joint during movements.

Hip Internal Rotators

The muscles that are responsible for twisting the leg inwards (Internal Rotators) are,

  •  Anterior portion of the gluteus medius
  • Tensor fasciae latae

The head of thigh bone (femur) rotates inwards within the hip joint. It also occurs in standing when the lower limb is fixed and the trunk/pelvis rotates as already seen in hip external rotation. Internal rotation is the exact opposite.

In the open kinetic chain, the internal rotators turn the lower limb inwards in relation to a fixed pelvis. This action is seen with the movement of the hip with knee flexion as seen in Fig 19.

Fig 19: Open chain internal rotation of hip joint

Hip Internal roation

Similarily, Fig 20 shows a closed chain right lower limb, upon activation of the internal hip rotators driven by the person’s pelvis and rotation to the Right side simultaneously (clockwise rotation) along the vertical body axis about the fixed right limb.

Fig 20: Right hip internal rotation and right side pelvic rotaion

Twist IR

Role of internal rotators

During walking, in order to sufficiently extend the hip toward the end of the gait cycle, there has to be enough hip internal rotation (Fig 21). Without sufficient internal rotation, the pelvis will move as far forward over the stance leg, and we instinctively shorten our stride.

Fig 21: Hip extension and internal rotation of left hip joint in the final phase of the gait cycle.

gait IR

In conclusion, a thorough understanding of pelvic and hip anatomy is important for undermining any cause of dysfunction or injury. Even a lack of range of motion due to tightness in the soft tissue structures can put you at risk of involving compensatory movements that can lead to postural problems. Always seek medical advice when in doubt.

Functions of the Patella – Knee Cap

anatomy, Common conditions, knee, Lifestyle, Pain

knee cap

The only time feeling weak at the knees would be a normal phenomenon is when you are standing at the edge of a cliff or doing a bungee jump.

Experiencing weak knees with joint pain can be quite debilitating. We can sit, stand, walk, run and move about easily because of our knees. What we should know is that our kneecap is a part of the knee joint and it should remain ‘in the groove’  for optimal function.

The kneecap, also called the patella bone, is a sesamoid bone in the front of your knee. It’s called the sesamoid bone as it has the shape of a sesame seed. The sesamoid bone is a bone that grows within a tendon. The patella has many biomechanical functions which are responsible for the protection, support and movements at your knees.

Anatomy of the knee cap


The knee joint (Patellofemoral joint) is comprised of the three bones. The thigh bone (Femur), the shin Bone (Tibia) and the patella (Kneecap). The patella  lies in a groove at the lower end of the femur and acts as an attachment point for the four main muscles of the thigh (quadriceps). The lowest part of the patella continues on as a tendon that attaches to the tibia. The muscles pull on the patella and the patella pulls on the tibia allowing you to straighten your knee from a bent position.

knee extension action

Cartilage of Patella

articular cartilage of patella

The cartilage is a taut protective structure underneath the kneecap. It found to be among the thickest cartilage in the body providing cushioning for the patella bone. The cartilage helps to prevent friction and acts as a shock absorber protecting the bony surfaces.

Why is the patella so important?

  • Patella functions as a natural pulley

The kneecap plays an important role, it increases the leverage of the quadriceps tendon (thigh muscle tendon) and protects the front of the knee from direct trauma.

lever arm quads

The quadriceps muscle is providing the force like the man in the picture, the patella bone acts as a fulcrum to provide more leverage for lifting the stone.

In real life though, the patella is a little more complicated by not only providing increased force, but also by aiding in balancing forces as well as providing a direction for the forces.

  • Prevents excessive weight-bearing compressive stress 

As weight bearing stress falls on our knees, the patella acts as a spacer protecting the quadriceps tendon and bone from coming into compression and creating a frictional force. The patella also allows for smoother movements when bending and straightening the leg.

  • Maintaining the Quadriceps Angle

Q angle

The quadriceps angle or the Q angle is determined by drawing one line from the hip bone (anterior superior iliac spine) through the center of the patella and a second line from the center of the patella through the leg bone (tibial tuberosity).

normal Q angle

As the Q angle increases above 15 degrees, it potentially could cause the patella bone to move out of its groove. This is as if the Q angle is increased, forceful contraction of the quadriceps muscle can cause the patella to move outwards and possibly dislocate. Slight changes in the Q angle would cause imbalances in the muscle forces causing compression stress, symptoms of pain and inflammation at the knee joint.

Knee Pain related to the Patella 

Although patellar dislocation, fracture, and patellar tendon inflammation are the common sports-related injury. Many patella related problems may also occur during daily activities.

  • Runner’s knee/ Patellofemoral pain syndrome 

Patellofemoral joint pain is a condition seen in runners causing pain during running or while at rest. Pain usually occurs in the front of the knee.

  • Condromalacia Patellae (“soft cartilage under the knee cap”)

This often affects young, otherwise healthy athletes. Chondromalacia patella is one of the conditions that cause pain in front of the knee. When pain exists in the absence of cartilage softening, it can be referred to as patellofemoral pain syndrome (Runner’s knee). Although it’s common to sporting individuals, it can also affect individuals with weak quadriceps muscles. It is common among individuals engaging in activities like football, cycling, tennis, weightlifting, runners. In other words, any sport that involves running, jumping, squatting and landing on the knees.

  • Prepatellar bursitis (between patella bone and skin)

Prepatellar bursitis has historically been referred to as “housemaid’s knee”, which is derived from a condition that was commonly associated with individuals whose work necessitated kneeling for extended periods of time. Prepatellar bursitis is common in professions such as carpet layers, gardeners, roofers, and plumbers.

  • Infrapatellar Bursitis (Below the Kneecap)

This is common among individuals who engage in activities that involve kneeling down for long hours causing inflammation of the bursa below the patellar tendon. It can also occur conjunctively with a condition called jumper’s knee.

  • Suprapatellar Bursitis (Above the kneecap)

Injuries such as direct trauma and overuse injury to the bursa beneath the quadriceps tendon cause inflammation of this bursa.Overuse injuries caused due to running on uneven surfaces or doing jobs that require crawling on the knees.

  • Osteoarthritis 

Patellofemoral arthritis occurs when the articular cartilage on the underside of the patella wears down causing friction between the patella and the end of the thigh bones. It gets extremely painful during weight bearing with swelling, inflammation around the knee. It is generally a degeneration condition which requires immediate medical attention to manage the condition.

  • Patellar Dislocation 

This type of injury happens when the kneecap (patella) moves out of its groove due to the sudden change in direction engaging in high impact sports. It most commonly occurs among young girls or hypermobile individuals due to laxity and increased hip angle. Direct trauma to the kneecap could also cause dislocations.

As a precautionary measure, using knee pads during sports and regular exercises of your knee muscles will have great benefits for your patella. Generally, most of the injury conditions can be managed with appropriate treatment and rehabilitation.

However, if you’ve only begun to feel pain while doing activities or just by standing, you might like to seek medical attention to prevent long-term pain or further damage to your patella.


Refined Carbohydrates – Don’t blame the butter for what the bread did.

Food, Lifestyle

 Variety of uncooked pasta and vegetables

I start to get tired, I start to get headaches; my liver basically starts to fill up with fat because there’s so much fat and sugar in this food. My blood sugar skyrockets, my cholesterol goes up off the charts, my blood pressure becomes completely unmanageable. The doctors were like, ‘You have to stop!’

These were the words of Morgan Spurlock, the man who had MacDonalds everyday for a month for an experiment on a fast food diet.

Most experts recommend that carbohydrates (Carbs) should be about 50 to 55 percent of your total daily calories for maintaining good health. However, according to a study by American Journal of Epidemiology 2013, carbs that have been stripped of their nutritional value are as good as consuming cholesterol-rich foods, leading to life-threatening conditions.

There are two basic types of carbohydrates, simple and complex carbohydrates. The way we get it now – there are refined carbs (artificially made) and unrefined carbs (available in natural form).

Metabolism of Carbohydrates


All carbs eventually break down into glucose to provide energy for the body. The only difference is the time taken by different carbs to break down into glucose.

  • Simple and complex carbs (refined or unrefined). Both are broken down to glucose with a series of metabolic changes.
  • As blood glucose level rises, your pancreas produces insulin. The hormone that helps your body cells (muscles, brain) to absorb blood sugar for energy and some of the glucose is stored as glycogen in the liver.
  • As cells absorb blood sugar, glucose levels in the blood begin to fall. When this happens, the liver then starts releasing the already stored sugar.
  • This interplay of insulin from the pancreas and stored glycogen from the liver ensures that cells throughout the body and especially in the brain, have a steady supply of blood sugar.

Carbohydrates – Refined vs Unrefined

“Refining” is a process applied to both simple and complex carbs. Refined carbs have a longer shelf life and enhanced taste. In exchange, you lose the fiber, nutrients, water and other benefits of the food as compared to its unrefined (natural) state. Unfortunately, this process also concentrates the sugar content causing a spike in blood glucose levels when consumed.

Refined Sugar

It is available in various forms of sugar like glucose, fructose and sucrose (table sugar, brown sugar, molasses, jams, jellies, processed honey, etc). These are all simple carbs. They are small molecules and are quickly absorbed as glucose in the bloodstream.

sugar food

Refined grains

These are commonly used as refined flour to make processed foods like commercial breakfast cereals, bread, tortillas, and many junk foods that contains a lot of starch. When eaten, they are broken down into sugar by the digestive tract. They convert rapidly into simple sugars and have a similar or if not worse effect on your body as refined sugars.

Refined Carbs (both Simple and Complex Carbs)

The Health Promotion Board in Singapore recommends whole unrefined grains and to limit refined sugar intake to no more than 10%(8-11 tsp) of your daily dietary energy. Studies have also shown that processed carbohydrates may increase the risk of obesity, diabetes, brain and heart problems, more than fats, because of its growing ill-effects.

Bad Effects of Refined Carbs

Pro-inflammation – “Slow fire rising within you”

  • Spiking blood glucose levels leads to increased  pro-inflammatory free radicals. Excess glucose and insulin in the blood causes inflammation of the cells of the blood vessels. In response to this, your body uses fat to be deposited around the inflamed cells causing the formation of atherosclerosis, increasing the risk of heart disease.


  • Excess glucose in your body is also stored in your liver by converting it into glycogen. Excessive sugar can fill your liver glycogen stores to its maximum capacity.  To compensate for the overload of glucose in your blood, your liver converts all the stored glycogen into fats causing the inflammatory process in your body.
  • Refined foods also elevate C-Reactive protein levels which will be identified by a blood test. It is an indication that there are high levels of inflammation in your body.
  • Excessive gluten consumption on the other hand not only causes inflammation of the blood vessels but also inflames your gut.

High Insulin Levels – “Are you at risk of getting diabetes?”

sugar diabetes

Glucose in the blood stimulates the pancreas to secrete insulin. Excess glucose in the blood causes excess insulin secretion. As insulin’s role is to absorb and help store sugar in your blood, excess levels of insulin can drop blood sugar levels very quickly as it stores it rapidly. If blood sugar levels go down too fast, it can cause the body to crave for more sugar. But if you eat food that is too high in glucose again, it can create a vicious cycle as the blood sugar levels are never adequately balanced. If this glucose roller coaster ride goes on for months, it can have short term consequences on your mood and concentration. Long term exposure puts you at increased risk of type II diabetes. This form of diabetes means the body becomes insensitive to insulin and the excess sugar in the blood can lead to chronic inflammation of blood vessels, which in turn can lead to heart disease or other severe illnesses.

Leptin Resistance – “I always feel hungry in the night”  
Leptin is a hormone that is released by fat cells to give the body a feeling of ‘fullness’ or satisfaction. By feeling satisfied by the food we eat, we can avoid taking in excess food. If we lack leptin, it will make us hungry. This is the body’s mechanism to ensure we get the exact amount of energy we need.  If we ingest foods high in sugar, it interferes with leptin function and this means we can eat far more than our body needs and still not feel full. If we continue to eat foods high in sugars, the brain can become addicted at the same time and fail to get satisfied by the food.
Loss of Nutrition Reserves – “Sick and tired of being sick and tired?”

Your body needs essential nutrients from your food in order to metabolise sugar. Refined foods are of very low nutritional value so the body is unable to properly control and regulate sugar metabolism. Your body still has to obtain these nutrients from other sources, causing a depletion in your nutritional reserves making you feel tired.

Brain function – “Something’s not right”


Glucose rollercoaster rides puts the brain (mood, concentration, thinking) on a roller coaster ride as well. There has been studies showing links between refined sugar consumption to hyperactivity, attention deficit hyperactivity disorder (ADHD), anxiety, irritability, reduced performance in school, juvenile delinquency, mental illnesses like schizophrenia and even increased criminal behavior.

Gastro-intestinal disorders – “I feel bloated”

Fibre content is reduced in refined complex carbs, this affects the function of the gut causing unwanted side-effects like excessive production of gas. This gas causes discomfort, bloating and flatus in many people. Digestive disorders come from constipation – difficulty to have a normal bowel movement.

Obesity – “I eat when I’m hungry and I’m hungry all the time”

Fructose is associated with increased fat deposition, which results from bad effects on hormones associated with satiety. Insulin-induced low blood sugar will specifically increase appetite and hunger for more carbohydrates, especially those with sugar content. Diet high in sugar content may cause greater appetite and increased hunger leading to obesity. Sugar is effectively addictive for the brain.

Eating in moderation is key and always consult an expert about your nutritional concerns when in doubt.

Avoiding the Glucose Rollercoaster

Food, Geeky stuff, Lifestyle

Several types of white sugar - refined sugar and granulated suga

We are all aware that Glucose is a primary source of energy for the body. it requires no further digestion and is available in your blood. Carbohydrates (carbs) is one such food group that breaks down into glucose during digestion.

The type of carbs that you consume will determine the amount of glucose present in your blood. The Glycemic Index (GI) is one such indicator which scales from 0 to 100, telling you the glucose level in your blood. The lower the GI, the better the food is for your body during the energy conversion process. Foods rich in protein and fats usually don’t have a GI value. While they do cause an eventual increase in blood sugar level, the process is slow unlike carbs/sugars which can cause an immediate spike.

Generally, when eating high GI foods together with proteins and fats, it slows down the body’s ability to convert the sugar as quickly. Slower sugar conversion results in a lower blood sugar spike. What this means is, if you ingest a fast-absorbing protein like casein which is found in milk, even though you will increase overall sugar levels, you decrease the effect of insulin and delay excessive absorption of the sugars in your blood. This in essence lowers the GI load on your body.

GI Standard Values (GI Low- less than 55, GI High- above 70)

Most fruits, vegetables and whole wheat foods  that we consume are on the lower side, with values in the 30s and 40s. On the other higher side of the scale, potatoes rank way up in the 80s, and white bread falls in the 70s.

White Pasta vs White Bread – Both made from Refined flour


Non-whole grain bread and pasta noodles both contain similar amounts of starch. Their starches are similarly composed of long chains of the simple sugar, glucose. The structure of bread allows more of the starch to be exposed to enzymes in our saliva and in our digestive tract. This greater exposure to enzymes allows more of the starch to be broken down into sugars giving white bread a higher GI value than white pasta. Effectively, both are still high on the GI value scale so moderate consumption will be recommended.

Insulin Insensitivity

The problem with ingesting foods with a high GI load over a prolonged time  can cause your body to become insensitive to a hormone called insulin. In the early stages (pre-diabetic) this can be reversible by making dietary and lifestyle changes. If no changes are made, and the person continues to eat high quantities of GI rich foods, it can lead to type II diabetes.

Know the GI but also the nutrient profile of your foods 

While a very high intake of GI rich foods should be avoided, you must remember that GI load does not measure nutritional intake. The body needs more than sugar for health and some foods while high in GI values, may have benefits that outweigh the disadvantages. Like brown rice, bananas and oats are all foods high in GI values, but they are also high in important minerals, vitamins and proteins essential for a healthy body. Balancing the benefits of reducing GI load while also making sure you get your full nutritional requirements is much more important. Portion size also plays an important role when it comes to such foods.

Much research have shown the benefits of low GI diet in weight loss, lowering the risk of diabetes and eliminating the sudden sugar rush and crashes. However, some studies have also shown no difference in hunger, satiety, or energy level after eating high- or low-GI foods. With research, the results of studies can’t necessarily be replicated and generalized for everyone but yes, for people who eat only high GI foods knowing its bad effects is a must.

Eating sensibly is the key!

healthy snacks

Everybody is unique with different metabolisms. Having said that, people’s metabolism also have different effects on blood glucose levels.  And most often, we eat foods in combinations of all different nutritional values. All we have to understand is that even if research trials have shown the benefits of low GI diets, in reality, it is best to only incorporate the knowledge rather than eliminating all high GI foods. That would be impractical and impossible.

Here are some GI values of the most commonly eaten foods.

Enjoy eating healthy and making healthy choices because what makes you feel better on the inside will show on the outside.

High-carbohydrate foods   Breakfast cereals   Fruit and fruit products   Vegetables  
White wheat bread 75 Cornflakes 81 Apple, raw 36 Potato, boiled 78
Whole wheat/whole meal bread 74 Wheat flake biscuits 69 Orange, raw 43 Potato, instant mash 87
Specialty grain bread 53 Porridge, rolled oats 55 Banana, raw 51 Potato, french fries 63
Unleavened wheat bread 70 Instant oat porridge 79 Pineapple, raw 59 Carrots, boiled 39
Wheat roti 62 Rice porridge/congee 78 Mango, raw 51 Sweet potato, boiled 63
Chapatti 52 Millet porridge 67 Watermelon, raw 76 Pumpkin, boiled 64
Corn tortilla 46 Muesli 57 Dates, raw 42 Plantain/green banana 55
White rice, boiled 73     Peaches, canned 43 Taro, boiled 53
Brown rice, boiled 68     Strawberry jam/jelly 49 Vegetable soup 48
Barley 28     Apple juice 41    
Sweet corn 52     Orange juice 50    
Spaghetti, white 49            
Spaghetti, whole meal 48            
Rice noodles 53            
Udon noodles 55            
Couscous 65            
Dairy products and alternatives   Legumes   Snack products   Sugars  
Milk, full fat 39 Chickpeas 28 Chocolate 40 Fructose 15
Milk, skim 37 Kidney beans 24 Popcorn 65 Sucrose 65
Ice cream 51 Lentils 32 Potato crisps 56 Glucose 103
Yogurt, fruit 41 Soya beans 16 Soft drink/soda 59 Honey 61
Soy milk 34     Rice crackers/crisps 87    
Rice milk 86            

High Heels – Your Guide to Making the Right Choices

Common conditions, Lifestyle, Pain

kitten heels

What if experts could tell you that high heels could be safe for your feet. Ever noticed that your friend can wear their 3-inch stiletto heels all day without complains while you can barely walk 3 steps in the same height? Well, it’s not because your colleague has a good pair of shoes. It’s actually because you’re wearing the wrong pair!

Things to look out for when buying heeled shoes

Every person is different with varying shapes and feet sizes, making it difficult for experts to give a specific number for the number of inches you can add to your heels. Here are few recommendations that they give depending on the structure of your feet.

Check your ankle range of motion (ROM)

The ankle joint is formed where your leg bone (Tibia) articulates with one of the foot bone called talus. Below the ankle joint is a small fluid-filled cavity called sinus tarsi. The size of the sinus tarsi  determines how much your ankle can move. If the movement of your ankles are restricted due to lack of flexibility in your ankles or due to small sinus tarsi, then wearing high heels would lead to ankle pain.

sinus tarsi

Test your ROM for high heels

In sitting position, straighten your knees and move your ankle from neutral position downwards to know your range of ankle plantar flexion. This range is from 45-55 degrees normally but may vary from person to person.

Print 18_Estes_Pages

If any high-heeled pair of shoes puts your feet beyond your normal range of ankle plantar flexion, then you will start with pains in your feet, knees, hips or back. A simple way is to look for shoes with a platform wedge in the front so you’ll get your forefoot elevated as well.

wedge platform

Correct Fitting Shoes

The Back of the shoes

Ensure that the heel counter fits you properly and fits well at the back of your heel to prevent your feet from slipping out as you walk.  If there is a gap between your heel and the shoe, friction blisters that may form as a result and could lead to Hagland’s deformity.

loose fit shoes

You may also want to pay special attention to the back of your feet when wearing sling-back shoes. Such shoes may rub against the back of your heels, causing pain and inflammation.

The Front of the Shoes

Proper shoe size is crucial to prevent the tip of your toes from hanging off the shoes in the case of open toe shoes. Notice the shape and the size of the toe box. If it is too big, you risk getting friction blisters from over-clenching your toes in an attempt to prevent it from slipping out of the shoe. This will shorten the soft tissues resulting in hammer toes. Shoes that are too tight or small will also put pressure on your toes and heels, leading to painful hammer toes, corns, and blisters.

hammer toes in shoes

The Shape of your heel

The pointy stiletto heel puts more pressure on the ball of your foot while wedged heels, which are thicker, distributes your body weight over a larger area of your foot.  The wedged heel usually has a skinny center with a slightly wider bottom, providing slightly more stability as compared to the pointy stiletto heel.

wedges or stilettos

Contrary to  popular belief, wedged heels are not stable. There’s little flexibility for your feet and you have to lift your whole foot right off the ground to walk, stomping your foot back down afterward.

The position of the heel is another key indicator. Ideally, it should be located right under the heel bone and not at the back of the foot. You are going to be thrown off balance if the heel is positioned too far back.

Pay attention to the “slope” or “pitch” of the heel. 

high vs low heels

2-3 inch Heels

Whether you are at college or working all day, a 2-3 inch comfortable pair of shoes will be enough to support the movements of your ankle and not place it in a vulnerable state for injuries. Kitten heels shoes will not only save you from foot troubles but it will lend a trendy feminine look with your dress. For most women, the recess of the sinus tarsi is moderate. The 2-3 inch heel will have a gradual slope of about 20-30 degrees plantar flexion, therefore, will be more comfortable.

Above 3 inches

Some 3.5 to 4-inch heels will have a straight drop down to the front portion of the shoe putting increased pressure on the forefeet. That is bad for your feet as it overloads the weight on your toes and balls of your feet. Such heels should be worn only occasionally and are definitely not suited for walking as it’s likely to cause foot problems with prolonged usage.

Arch Support

Those who have noticed their sole lays flat on the ground may have excessive movements in their foot joints. This condition is known as flat feet and wearing high heels may feel comfortable as they put your feet in an arched position. However, it’s best to avoid excessively high heels for unstable joints. Similarly, it’s better for people with stable joints to wear lower heels, as long as they are supportive to their arches.

If you choose the right pair of shoes for your feet, painful foot conditions could be avoided. In fact, you could enjoy wearing your heels all day without any problems. A sound advice would be to also avoid wearing anything too flat or too high for extended hours to prevent any damage to your joints and soft tissue structures.

Head over heels for Stilettos – Is it worth the pain?

Common conditions, Lifestyle, Pain

high heels

Most of us would desire to wear that pair of Louboutin’s or to own a pair from Lady Gaga’s shoe stash. Whether you want to steal a celebrity style secret or wear a pair to match your outfit, there’s no denying that women of all ages love them.

What high heels do 

They change your posture so that your lower back is arched, your pelvis and chest is thrust forward, the buttocks are tightened and the calf muscles firm. This makes you taller, feel slimmer and overall changing your silhouette. With the right pair, it also enhances your authority and presence.

As amazing as it sounds, wearing high heels can be a daily struggle for many women. Wearing the wrong size, shape and fit causes undue stress and pain in your calves, knees and back. Most women are unaware of the amount of stress high heels can place on their body. Back pain, hip pain, knee pain, ankle pain and/or foot pain can all stem from incorrect shoes.

Walking – Correct Pattern of Movements

The pattern of how our body parts move while we walk is called the gait. From the time your heel strikes to the next time the same heel strikes again, there are a series of movements occurring at your hips, knees and feet.


Posture, Centre of Mass and Gravity

Correct posture improves muscular function and brings stability to your moving body. Your stability is also determined by a mid-point in your body that has the most gravitational pull, this shifts according to body movements.

Body Stability
Think of a car as the moving body and the gravitational force acting at its centre. If this car had to tilt sideways, the centre of mass and line of gravity would be shifted to the heavier side, causing an imbalance in forces.
car and gravity.
Wearing High Heels

Your ankle is forced into an unnatural downward position and the body adapts itself to maximise limb stability. Putting you in a highly unstable and vulnerable position to sustain an injury during movements.

When standing straight up without heels, your body creates a 90-degree angle on the floor, which is normal stance. Think of your body being a rigid column, putting on a pair of heels would force your body to tilt forward. The angle between the floor and heel would decrease from 90 degrees to 70 degrees.

angles with floor

However, the body is NOT a rigid column. Our posture adjusts to maintain stability and these adjustments pose greater stress on our back, knee, ankle and foot.

Postural Changes

High heels change the alignment of your spine, hips, knees and ankles pushing your centre of gravity forwards. This causes excessive pressure on the front of your knees.


Muscular Imbalances

Prolong use of high heels can cause excessive shortening of calf muscles resulting in the thickening of the Achilles tendon. Walking around barefoot or in flat shoes may cause pain and discomfort. If you are experiencing this, it may be time to seek treatment before it is too late.

achillis tendonitis

High Heels vs No Heels

During normal stance, body weight is spread evenly from the heel and ball of the foot. So, the center-of-pressure (COP), where the most weight is distributed, is located in the middle of the foot.
When standing in high heels, the shift in angle causes the body’s weight to tilt forward. The center of pressure is shifted to the ball of the foot. 90% of the body weight is now focused on the ball of the foot.
pressure areas

High heels and joint problems

The higher the heel, the greater the stress potentially causing strain, pain and stiffness of the ankle and knee joint structures. It is also been reported that wearing heels more than 3 inches over time puts women more at risk of ankle and knee osteoarthritis. The effect is worsened in overweight cases.

Painful conditions due to High Heels

  • Bunions

Bunion is a condition when your big toe joint begins to lean inwards and becomes enlarged. It is more likely to be triggered by wearing very pointy shoes or  shoes that are too tight on your toes. You start with swelling, redness, tenderness and pain at the base of your great toe even when you’re barefoot. Over time, your big toe deforms and pushes inwards towards the other toes. This changes the normal positioning of your toes, spreading pain in the front of your foot and a loss in foot aesthetic will also occur.

Toe alignment correction

  • Metatarsalgia

This is a symptom caused by excessive stress and inflammation on the front of the foot while standing in high heels. It is felt on the metatarsal heads and pain gradually increases over weeks rather than suddenly. The front area of your foot may also feel tender when you press on it. The pain lasts during weight bearing and depends on the extent of stress on your metatarsals.


  • Hagland’s Deformity

High heels with back straps that are constantly rubbing against the upper part of your heel cause Hagland’s deformity.

You’ll notice:

  • A bump on the back of the heel
  • Pain in the area where the Achilles tendon
  • Swelling and redness in the back of the heel

foot deformity

This will eventually lead to bursitis. A Bursal is a fluid-filled sac that separates tendons from bones. An inflammation of this sac is called bursitis. Bursitis will cause Achilles tendonitis and make the bump even more prominent and painful.

  • Hammer toes

Excessive and prolonged weight and stress deform the toes into a bent position which does not correct even at rest. The muscle and ligament imbalances over the toes cause inflammation and rigidity leading to arthritis.

hammer toes in shoes

Walking on a Marble – Morton’s Neuroma

This condition is caused due to excessive thickening of the tissues around the nerves of your toes. The most frequent location is between the 3rd and 4th (3rd web space) and less commonly in 2nd and 3rd metatarsals (2nd webspace) as the foot is narrower between the third and fourth metatarsals. This means that the nerves that run between these metatarsals are more likely to be compressed and irritated.

You will feel pain worsen when walking barefoot or if the metatarsal heads get squeezed together in your narrow fitted shoes. Pain comes and goes intermittently. You may experience severe pain attacks from two to several times in a week.


Although there are many painful conditions associated with the use of high heels, the demands for it keep increasing because of fashion trends and downright vanity.

It would not be wise to sacrifice fashion for health and comfort. But with every problem, there is always a solution. Wearing just the right height of heels will help ensure good foot placement and minimize injury to your body. If you are a fan of high heels, you may want to seek expert opinion on how to maintain foot health or wear insoles to ensure good arch support and equal weight distribution. The solution may not be a perfect one, but we always aim to create a solution nonetheless. It’s easy to say ‘no, stop doing it’ but why people come to us is as we create imperfect solutions in order to let people keep doing what they love.

Common Lifestyle Errors



You may want that six-pack abs and the best bikini body to look great and be happy. Whatever your goal may be, before you even start-up with your journey of exercise regimes, you may want to consider what “healthy” means to you.

This is the problem: Our bodies can put up with our silly movements and lifestyle choices because they have this immense capacity to tolerate and adapt. We shouldn’t, however, make the mistake of putting our bodies in a compromised state by eating, sleeping or moving however we please. Some of the most common injuries to your muscles, bones and joints are really from lifestyle errors and totally preventable. You should know this because your body has this extraordinary capacity to self-correct with just  little input.

Bad Posture

Rounded back, shoulders rolled forward, overextended spine, feet turned out, head tilted up or down and elbows flared out.

Bad Posture- Osteopathy

The idea behind a bad posture is that it places excessive stress on all the muscles resulting in increased tension which can eventually lead to pain.

Muscles are responsible for bracing all the joints of our body and carry much of our body load. In order for our muscles to work better, it should be in its optimal length. In bad postures, muscles weaken and lose their optimal length eventually as they adapt. This may not necessarily cause pain in the beginning, but with time may lead to painful conditions of your soft tissues and joint structures.

No warm-up or Cool down

So what’s the big deal?

Osteopathy- Warm-up

Warm-up exercises are like low heart rate cardio which will prepare the circulatory and respiratory system for the upcoming workout. It improves the flexibility of your muscles whether it’s just walking or running. On the other hand, cool down exercises help you to gradually lower your heart rate and blood pressure. They also restore flexibility to your muscles without which you may get light-headed post-workout or sustain muscle ache the next day.


It’s a myth that one can get dehydrated only if you sweat during exercise. You can actually also get dehydrated even while sitting all day in an air-conditioned room.

Dumbbells, apple, measure tape and bootle of water

Our body is two-thirds water and 75% of your muscle is water. When this level of hydration in our muscles falls too low, it leads to dehydration causing decreased blood flow to all the muscles and a drop in blood pressure.

Poor Nutrition

Don’t guess when it comes to something as important as your nutrition.

Osteopathy- Nutrition

If your goal is to build a strong and lean body, all the training in the world won’t help if you aren’t ingesting the right fuel in the right amounts. Your body needs specific nutrients to recover and grow. Simply put, if you eat healthily you stay healthy.

Prolonged Sitting

Are you a Couch Potato?

Osteopathy couch-potato

Studies have shown that being sedentary is more lethal than being obese. “Were there any times in your life when you were more active?” “How can we get you to be more active?” It’s not necessary to always hit the gym for a workout but just engaging in your favorite sports or going out with friends for leisure or just dancing to Taylor swift’s “Shake it Up” would be great way to reduce your sedentary time.


Change is Constant!

Osteopathy stressed

But with the changing environment, one must learn to maintain internal well-being. Anything that threatens our health is a stress and finding the best course of action to deal with it is the ultimate solution.

Insulin insensitivity

Say Hello to high blood glucose!

Osteopathy Prediabetis

Every part of our body needs energy to function. This energy comes from the food that we eat. The carbohydrates in the food break down to glucose and then our body needs insulin in order to use or store this glucose for energy. Without insulin, glucose stays in the bloodstream, keeping blood sugar levels high. Insulin insensitivity is a condition when your body is insensitive to insulin thus causing more glucose to be present in the blood.

Chronic inflammation

You don’t think you are sick but a fire is quietly rising up within you.

Osteopathy Inflammation

Inflammation is actually a life-saving response of your immunity that fights infections and subsides gradually helping the healing process. Chronic Inflammation is a long-term inflammation of the tissues, joints and cells of your body. It affects possibly everything your endocrine, central nervous, digestive, and cardiovascular/respiratory systems.

To sum up, let’s be more aware of the vital aspects that can significantly change the way you perform. In other words, you don’t have to be perfect all the time. Instead, try to make healthy lifestyle choices most of the time because they will make you feel good. That’s the only way you’ll stick with them!