some health related questions...

Pooja Makhija, a nutritionist answers some health related questions... 
When cola companies claim 'Diet' and 'Lite', what do they mean? Are these really low in calories? And are they safe for consumption on a regular and daily basis? 

Conventional aerated drinks are sugar-laden carbonated beverages. Their 'diet' counterparts are the carbonated waters without the 'empty sugar calories' rest of the remaining ingredients being the same. Yes, diet colas are low in calories (because the chief contributor sugar is missing). But they are not a dieter's dream! They may not have as many calories but do have artificial sweetener aspartame as the main sweetening agent. Aspartame have long list of harmful effects. Enamel erosion, bone loss, kidney damage, weight gain, frequent headaches, brain cell damage being the feared ones. I wouldn't consider diet sodas 'safe' for daily consumption. 
Health shops are selling palm jaggery, which they advertise as the safer alternative to sugar. Is this so? Can palm jaggery be substituted everywhere for sugar? 

Palm jaggery is collected as sap from date palm trees. It's a natural sugar substitute, with a lot of health benefits. It has natural cleansing properties that aid digestion and help remove toxins from the body relieving constipation. Jaggery is used as home remedy to help alleviate dry cold coughs, hiccups, migraines and more. Because of its mineral content, it also helps reduce water retention, bloating and lower blood pressure. It can replace sugar in most Indian recipes. Although jaggery has many medicinal properties versus refined white sugar, it does have the same number of calories (source parent is same) thus for those on weight loss programs, keeping consumption to a minimal should be considered. 
Pre-packaged salads with short shelf lives are being sold in departmental stores. Are these safe to consume? 

With the much created awareness about importance of fresh fruits and vegetables, but always falling short in time to procure them; prepackaged salads and salad bars are mushrooming all over. Remember that fresh produce always has a short shelf life, thus the best before date must be carefully observed before purchasing these items. In the quest to gain healthy fibre rich snacks, we should not contract unhealthy bacteria laden diseases. The salad should be ideally packaged and refrigerated immediately after cutting vegetables and must be consumed within a day for best nutrient availability. 
Is it harmful to have the yolk of egg? If I mix one yolk with the whites of five eggs in my breakfast omelets, would that be okay or am I still asking for cholesterol problems? 

No, consuming the yolk is not totally harmful, especially if not eaten daily. Yes, the yolk contains most of the fat (99 per cent) of the egg, but it also contains a chunk of the nutrients, including 90 per cent of the calcium, iron, Vitamin B6 + B12, zinc, and folate content. Majority of the protein (100 per cent complete in all essential amino acids) content is in the egg white, and since it has just 1 per cent of the fat; it contributes very little calories to the daily intake. Thus egg whites can be had in multiple numbers daily. 

8 glasses of water a day, is it nonsense??!!

A medical practitioner has argued that the recommendation to drink six to eight glasses of water a day to prevent dehydration is not only nonsense, but is thoroughly debunk nonsense.

There is currently no clear evidence of the benefit from drinking increased amounts of water, yet the we-don't-drink-enough-water myth has endless advocates including the NHS, claimed GP Margaret McCartney.

The NHS Choices website states: Try to drink about six to eight glasses of water (or other fluids) a day to prevent dehydration.

While many schools also feel it appropriate to insist that pupils are accompanied to school by a water bottle, other organisations, often with vested interests, reinforce this message, she said.

For example, Hydration for Health (created by French food giant Danone - makers of bottled waters including Volvic and Evian) recommends 1.5 to 2 litres of water daily as the simplest and healthiest hydration advice you can give.

It also claims that, even mild dehydration plays a role in the development of various diseases.

But McCartney disagreed that that there is no high quality published evidence to support these claims.

While there are some conditions that do benefit from drinking increased water, such as in people with recurrent kidney stones, other evidence for preventing disease is conflicting, added McCartney.

There are many organisations with vested interests who would like to tell doctors and patients what to do. We should just say no, she concluded.

Big breakfast does not make you lose weight.....

German researchers have suggested that eating a big breakfast may lead to gaining more weight. 

The study, which refutes previous findings that eating a big breakfast reduces total calorie intake over the day, found that those who enjoy a hearty breakfast are likely to have a big lunch and dinner. 

Volker Schusdziarra at the Else-Kroner-Fresenius Center of Nutritional Medicine, Germany, and his team conducted a study on over 300 people who were asked to note down what they usually ate. 

Within the group, some always ate a big breakfast, others ate a small one and some skipped the meal altogether. 

"The results of the study showed that 'people ate the same at lunch and dinner, regardless of what they had for breakfast," said Schusdziarra. 

This meant that a big breakfast boosted overall calorie intake. A big breakfast (on average 400 kcal greater than a small breakfast) resulted in a total increase in calories eaten over the day of about 400 kcal. 

The only difference was when people who ate a really large breakfast decided to skip a mid-morning snack. But this was not enough to offset the extra calories they had already eaten. 

According to Schusdziarra, the previous study only looked at the ratio of breakfast calories to daily calories while his study found that this ratio seems to be most affected by people eating less during the day. 

In other words, their breakfast was proportionally, but not absolutely, bigger. 

The researchers claimed that a large breakfast must be counteracted by eating substantially less during the day. 

In order to lose weight sensibly, the National Health Service guidelines suggest restricting calorie intake, cutting down on saturated fat and sugar, and eating 5-a-day fruit and vegetable. 

The study is published in Nutrition journal. 

Healthy & Stylish Hair This Monsoon

While we all love splashing about and getting soaked in the cool, welcoming shower, there is also a huge battle to safeguard one's hair. High pollutant levels of the rainwater, coupled with humidity, can prove disastrous. iDiva gets experts to chalk up a plan to keep the mane shiny and well-groomed this wet season. 

Dandruff and dull hair
What makes our tresses most unattractive is the dull look. "This happens  because of a mix of temperatures - humidity and heat take a toll on the texture of the hair," explains hairstylist Placid Braganza. "A good idea is to use a water-based serum, which is light, to protect the hair," he adds.    

Dirty rainwater can also cause dandruff due to flaky dryness of the scalp. Climatic changes always bring about change in hair care. A wet and sticky scalp also gives rise to secondary infections like dandruff and boils. All this leads to hair woes that must be sorted out. There are ways to do this at home.

Style it up
There are a lot of fun ways to wear one's hair in the monsoons. Putting your hair up is totally in for an unstructured yet fashionable look. You can also accessorise with flowers, feathers or a brooch. You can also scrunch hair up and tie it on one side for a formal or informal look. If it's a ponytail you like, twist it to make it look exciting and wear it on one or either side of your crown. In addition, you can opt for a French braid and add pearls to the knots. I'd recommend people with wavy hair to use some leave-in conditioner and then tie a ribbon or a scarf around their hair.

Avoid these at a salon 
While it might be tough to stay away from hairstyling if the occasion demands it, here are reasons why you ought to push away that hair appointment for a while. Says Robequin, "The humid atmosphere spells disaster for those with chemically-treated hair. During monsoons, your hair absorbs the moisture and this nullifies the effect of any chemical treatment or product used on the hair. The best thing to do is to give your strands a break during this season. Let them shape naturally and avoid blow-drying, ironing or using harsh chemicals." Agrees Braganza, "Hair bonding, perming and straightening are avoidable, as they require hair to be off moisture in the monsoon, which isn't easy."

Love your locks
Dr Nirmala Shetty recommends home-made hair spa treatments

For dry scalp

• 1/4 cup coconut oil
• 1/4 cup coconut milk
• 1 egg yolk
• 1/4 cup curd

Blend all in the mixer till you get a creamy mixture. Add two drops of ylang ylang essential oil in case the eggy odour disturbs you. Massage on scalp for five minutes. Wash after 20 mins.

For oily scalp

• 1/4 cup of methi (fenugreek) soaked overnight and ground to remove extract
• Paste of 5 hibiscus flowers
• 1/4 cup of brahmi leaf paste
• 1/4 cup of neem leaf paste
• 2 tsp coconut oil

Mix all and gently apply on scalp and hair. Remember, this time the massage has to be gentle and light.  
 
For Dandruff

• 1/4 Beet juice
• 1/4 coconut milk
• 1/4 cup curd
• 1 tsp lime
• 3 tsp olive oil

Blend and massage. In case of stubborn dandruff, repeat twice a week.

Dos

• Wash hair every alternate day with a mild shampoo.
• Use a leave-in conditioner after washing.
• Go in for moisturising hair treatments.
• Protect the hair with a cap or a stole in the rain.
• Oil hair once a week.

Don'ts

• Using hairsprays or gels.
• Excessive blow-dry treatments.
• Swimming without a cap.
• Sharing a hairbrush or comb.

Bling it on
Swarovski crystal clips and those with diamantes can add sparkle to your locks. Use them to jazz up your monsoon look!

Green Exercise for the Mind ?!

A new research has suggested that just five minutes of outdoor activity — such as exercising in a park, working in a backyard garden or walking on a nature trail — is good for the brain, with tangible benefits for mental health. 

It indicated that physical activity in natural areas, known as 'green' exercise, could lead to improvements in mental health. 

In the study, Jules Pretty and Jo Barton, Ph.D., of the University of Essex in the United Kingdom(U.K.), analyzed data on the physical activities of 1,252 people of different ages, genders and mental health status in the U.K. 

The scientists showed that just five minutes of exercise in a green nature setting could boost mood and self-esteem. 

The research appeared in a report in the ACS journal, Environmental Science & Technology (ES&T). ES&T also published a news article on the study. 

'Weight Loss' is in the Genes !!

The secret to losing weight could be down to a person's genes rather than how strictly they adhere to a diet, a research indicates. 

According to the study, some women are genetically programmed to have more success in shedding pounds through certain weight-loss schemes than others. The findings could explain why some people swear by the fat-rich Atkins diet to slim down, while others do better by stocking up on carbohydrates, reports telegraph.co.uk. 

Researchers from Stanford University in the US have made this discovery after taking mouth swabs from more than 100 overweight women who had tried various diets. 

They then analysed the women's DNA for five genes linked to how the body uses fat and carbohydrate. 

The team found that women following diets that matched their genotype or genetic make-up, shed nearly 6 kg on average over a year - almost three times more than the other women. 

These women also saw their waistlines reduced by 2.6 inches on average, compared with 1.2 inches.

Christopher Gardner of Stanford University, who led the study, said: "The differentiation in weight loss for individuals who followed a diet matched to their genotype versus one that was not matched to their genotype is highly significant and represents an approach to weight loss that has not previously been reported in literature." 

He added that using genetic information would "be important in helping to solve the pervasive problem of excessive weight in our society". 

Beer Belly??

Tired of your paunch bringing you down? Here is how you can turn your beer belly into six-pack abs

Those who think they don't have time for exercise, it is said, will sooner or later have to find time for illness. For men today, piling on the kilos without squeezing in any exercise routine in a hectic work schedule has meant indiscriminate weight gain and growing obese, which heightens the risk of diabetes, heart disease and cancer among other fatal ailments. 

 In fact, when it comes to losing weight, men have a clear head start over women because of men's higher testosterone levels that help burn more calories and build more muscle — even when resting. Here is how to get started and target some of the key male body blackspots: 

Double chin
A chubby jaw and jowls is a sign you are carrying too much weight overall. Plus the chin is where fat tends to settle more as we age. 

Best fat blaster: Phone trainer app 
Losing fat from all over will help shed flabby jowls, as will toning the neck and under-chin muscles. Try using a personal fitness app on your mobile phone to get motivated, to get moving. Your own pocket 'trainer' is cheaper than a real one. It can also tell you how often you need to work out, based on your calorie intake that day. 

Top move: The Goldfish 
With your head straight, simply open and close your mouth like a goldfish. Then, tip your head back as far as is comfortable for your neck, open and close your mouth. You will feel the tension beneath your chin. Repeat 10 times daily. 

Arm flab 
It is not only women who get bingo wings. As men age, the skin can lose some elasticity and fat can collect on the underarms. 

Best fat blaster: Kettlebells 
A new kind of free-weight, kettlebells can be used to upgrade any workout. They have their centre of gravity in the middle, which means they not only tone arm muscles, they also force the 'core' stomach and back muscles to work harder. 

Top move: Bicep curl 
You can use any arm weights for these — even a two-litre bottle of water will do. Hold your weights down by your sides with your palms facing upwards. Without moving the upper part of your arms, slowly bend your arm and bring the weights up to your shoulders. Repeat 12 times, doing three sets.

Moobs 
The chest area is another man-fat magnet, so it's no surprise that men have problems with this portion once they pass 35 and sport what is popularly known as 'man boobs'. 

Best fat blaster: bikram yoga 
Yoga done in a heated room is not just for girls. In fact, this hardcore style of yoga gives your body a proper workout. 

Top move: Press ups 
Lie face down on the floor with your hands by your chest. Your elbows should be bent with your palms completely flat and facing forwards. Raise your body off the floor by straightening your arms, keeping your body straight. Hold for a second, lower your back down, keeping abs tensed. Repeat 12 times. 

Beer belly 
Beer belly gets its name for good reason — booze is packed with calories. But male muscle structure means all men have a readydefined six-pack — even if it is currently hiding under several layers of fat. 

Best fat blaster: Skipping 
Skipping for 10 minutes can burn a good deal of calories. It uses nearly every muscle and will shift hardto-reach belly fat in no time. 

Top move: Tummy tenser 
Lie flat on your back and lift your legs into the air so they are as close to 90 degrees from the floor as possible, pulling in your ab muscles as you go. Lower your legs a little and hold for a count of 10, then lower a bit more and hold again for 10. Then lower them till they are almost touching the floor and hold again. Finally, bring your legs up to your chest and rest. Repeat three times. 

Love handles 
That stubborn spare tyre is all thanks to a man's higher levels of testosterone, which causes fat to be stored around his middle. 

Best fat blaster: EA Sports Active 2 game 
Similar to Wii Fit, but also available on the Xbox 360 and PS3, this home workout set features real sports, including basketball and boxing. It uses leg and arm motion sensors to wirelessly track your training. 

Top move: Alternating sit-ups 
Lie flat on your back with your knees bent. Put your hands behind your ears and sit up, aiming your left elbow at your right knee. Next, sit up again but this time aim your right elbow to your left knee. Continue switching sides like this 15 times. 

Puny pins 
Unlike women, men don't tend to carry a lot of fat on their legs, but being unfit can lead to the dreaded 'chicken leg' syndrome. 

Best muscle toner: Playing footie 
There's nothing better than football for strengthening and shaping legs. A recent study found middleaged men who still played regular football had a lower risk of heart disease and depression. 

Top move: Power lunges 
Stand with your feet apart and knees bent. Step forward so your front leg is one-stride from the back foot. As you do so, lower your body, then spring back to your starting position, pushing through the heel of your foot. Then repeat on the other side. Do 30 repetitions.

Cycling is not just an Exercise?

The debate on global warming heats up, the agenda is clear: A non-polluted environment and good health. Deny as much as you do, but there's a hidden concern amongst today's generation on where we are heading and in what condition. In our own ways, we are looking for ways to healthy living. Here's a viable option that's also an enjoyable one! 

Remember the old days where we could just ride away with a bicycle to almost any part of the town? If you visit a place like Puducherry (Pondicherry) and Chennai, there are still a good number of people riding bicycles. It's not just fun, but also healthy.  This is not only the best form of exercise, but also eco-friendly. If you are dreaming of a healthy future for the next generation, then perhaps you would consider this. 

Why cycling? Well, this is one of those exercises that doesn't exhaust you but pumps more energy. It also builds your stamina. Besides, don't you think it's the most convenient cost-effective way ofexercising? Visiting gym everyday demands time, energy to reach the place and a lot of money of course! Cycling on the other hand, can be done in the vicinity of your neighbourhood whenever you find time. Also, it's a one-time investment! And you could cycle with friends and also family members of all age groups. Not just that, it tones your entire body as you are utilising most parts of your body.  And for all those who are struggling to lose that stored fat in your body, here's a fun way. The best part about cycling is that it can be seen as a sport rather than a form of exercise. And mind you, cycling is still one of the popular sports in some countries. 

Cycle your way to health: Cycling is a cardio exercise which keeps the heart stronger, tones the body, helps lose weight and increases the supply of blood and oxygen in the body. There are many cardio exercises which may help improve body stamina but cycling is by far the most effective. It is often said that with cycling, the risk of heart diseases, diabetes, obesity and blood pressure can be reduced to a great extent. That apart, it's a great stress buster. Make cycling a habit not just for that toned body but also for lifting your spirits. Cycling does rejuvenate you and enhances your mood. Like any other forms of exercise, cycling releases endorphin which has positive effects on our mood. Hence after cycling for a great distance, you feel refreshed instead of feeling tired. Cycling also reduces the risk of fracture during a fall or an accident and helps maintain the strength and coordination. With regular cycling, the strength of the legs improve. 

For a better tomorrow: We all crib about bad weather, nature's fury, but do little about how we can reduce the danger levels. Automobile manufacturers are coming up with eco-friendly cars. But how about an eco-friendly, cost-effective (read fuel-efficient) and portable mode of transport? Yes, the bicycle is perhaps the best way to reduce/cut emission levels. Best thing is you can easily carry it wherever you go! Incorporate this change in your routine and you can definitely contribute to preserving our eco-system. You may love to flaunt your car, but there's no harm in dedicating a day for a better tomorrow. And why not when it can save you from respiratory diseases like asthma? 

How to select a cycle? 
There is no rule of thumb to select the cycle for you. Only remember to choose the one where your feet reach the ground when halted; this reduces the risk of falling off the bike. Prefer a cycle with gear when cycling towards higher grounds, this way you reduce the stress on the thighs and cut the risk of muscle tear. 

Do it the right way 
With the excitement of owning a new cycle, we ride long distances. This tires the entire body. It's better to start off with a 30-minute cycling for the first week and then gradually increase the time. And do wear protective gear like helmet, knee guard and the ankle guard to prevent any damage to your body 

Any amount of alcohol can give you cancer....!

When it comes to limiting your risk of cancer, there is no such thing as a safe' amount of alcohol, says a new study.

The findings will come as bad news for people who enjoy a daily tipple.

A team led by Paule Latino-Martel of the French National Institute for Agricultural Research said most nations including the UK and the U.S. set their drink limit guidelines to deal with short-term effects of alcohol and fail to take into account the long-term risks of light boozing.

There is no level of alcohol consumption for which the cancer risk is null, they concluded.

Latino-Martel and her colleagues said the WHO International Agency of Research on Cancer had found alcohol to be carcinogenic in both animals and humans.

They added that a joint 2007 report of the World Cancer Research Fund and the American Institute for Cancer Research warned of the link between alcohol and cancers in the mouth, throat, esophagus, liver, colon-rectum and breast cancers.

Therefore, the current sensible drinking' limits are inadequate for the prevention of cancer and new international guidelines are needed, they said.

On the whole, alcohol is considered an avoidable risk factor for cancer incidence and, more generally, for the global burden of disease, the Daily Mail quoted Latino-Martel as saying.

Although guidelines are currently practical for health professionals and health authorities, the time has come to reconsider them using a scientific basis independent of any cultural and economic considerations and to discuss the eventuality of abandoning them,'' she said.

Considering our current knowledge of the relationship between alcohol consumption and cancer risk, national health authorities should be aware of the possible legal consequences of promoting drinking guidelines that allow consumers to believe that drinking at low or moderate levels is without risk, she added.

The study appears in the Canadian Medical Association Journal .

Ways to keep cholesterol in check

Take psyllium 
The first, and one of the simplest tips, is to get more fiber in your diet - but not just any kind, because not all fibers work the same way. Viscous soluble fiber like psyllium fiber, the natural dietary fiber found in Metamucil, is proven to help lower total and "lousy" LDL cholesterol because it forms a thick gel that traps and helps remove some cholesterol, bile acids and waste in the gut. This is why I recommend my patients supplement low fat, low cholesterol diets with 7 grams of soluble fiber from psyllium daily, as in Metamucil. 
Wear a pedometer and increase daily activity 
You'd be amazed to see how many extra steps you can take in one day -- grab a pedometer and watch the numbers roll as you make simple changes for your health and take the stairs, walk to work, or stroll around the neighbourhood to increase your physical activity for better heart health. Tracking your progress throughout the day can be great inspiration to keep going, and walking is a simple and easy type of exercise to help lower cholesterol! 
Get an exercise buddy 
A healthy lifestyle requires motivation, encouragement and a friend to lean on. Grab an exercise buddy and support each other in the challenge to lower your cholesterol. Take long walks together and encourage each other to try new types of physical activity to get the heart pumping and to keep cholesterol levels down! Enjoy each other's company and laugh – reduced levels of stress will help your heart too! 

Beware of hidden fats and sugars 
Be an informed eater; get to know your ingredients and read the nutrition labels thoroughly. Hidden sugars and unhealthy ingredients can increase your weight, which can lead to high cholesterol. Stay away from foods that contain high levels of saturated fat, cholesterol and hidden sources of sugar such as high fructose corn syrup, some dextrins, or evaporated cane juice. 
Add DHA 
DHA is short for docosahexaenoic acid, a polyunsaturated fatty acid. Regular intake of DHA can aid in proper heart function and help lower levels of Low Density Lipoprotein (LDL), or the "lousy" cholesterol3, and raise levels of High Density Lipoprotein (HDL), or the "healthy" cholesterol. Popular sources of DHA are salmon, sardines, tuna – but if you aren't a seafood fan, try fish oil supplements, or if you don't like fishy taste, get them from vegetarian supplements made from algal DHA. 

Lost teeth.... can be grown again !

For the first time, scientists from the Tokyo University of Science have grown fully formed teeth from stem cells.

The artificial teeth that looked like the real thing, were sensitive to pain and could chew food.

Though the breakthrough was made on mice, it could pave the way for those who lose teeth to decay or injury to be able to grow' replacements.

Two types of stem cells, which between them contain all the instructions for making teeth, were mixed together and grown in the lab in a mixture of chemicals and vitamins that started their transformation.

After five days, they had formed a tiny tooth bud'. The fledgling tooth was then placed in a tailor-made plastic box deep inside a mouse's body, and ensured it had access to the fluids and chemical signals it needed to develop further.

Over the next 60 days it grew to form a full tooth, which was then taken out of the box and transplanted deep into the jawbone of a mouse that had had a tooth removed.

Six weeks later, it had fused with the jawbone, the study said.

The tooth had all the components of normal teeth, including enamel, crown and root, and connective fibres to fix it to bone.

The bioengineered teeth were fully functional ... there was no trouble biting and eating food after transplantation, the Daily Mail quoted Masamitsu Oshima, assistant professor at the Research Institute for Science and Technology, Tokyo University of Science, as saying.

Professor Takashi Tsuji of the University spearheaded the research.

The stem cell teeth that are likely to cost around 2,000 pounds each is still at an early stage and researchers say it will take at least a decade before people can grow their own teeth'.

The detail of the achievement has been published in the journal PLoS ONE .

Benign paroxysmal positional vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you're spinning or that your head is spinning inside.

Benign paroxysmal positional vertigo is characterized by brief episodes of mild to intense dizziness. Symptoms of benign paroxysmal positional vertigo are triggered by specific changes in the position of your head, such as tipping your head up or down, and by lying down, turning over or sitting up in bed. You may also feel out of balance when standing or walking.

Although benign paroxysmal positional vertigo can be a bothersome problem, it's rarely serious except when it increases the chance of falls. You can receive effective treatment for benign paroxysmal positional vertigo during a doctor's office visit.

Symptoms

• Dizziness
• A sense that you or your surroundings are spinning or moving (vertigo)
• Lightheadedness
• Unsteadiness
• A loss of balance
• Blurred vision associated with the sensation of vertigo
• Nausea
• Vomiting

The signs and symptoms of BPPV can come and go, with symptoms commonly lasting less than one minute. Episodes of benign paroxysmal positional vertigo and other forms of vertigo can disappear for some time and then recur.

Activities that bring about the signs and symptoms of BPPV can vary from person to person, but are almost always brought on by a change in the position of your head. Abnormal rhythmic eye movements (nystagmus) usually accompany the symptoms of benign paroxysmal positional vertigo. Although rare, it's possible to have BPPV in both ears (bilateral BPPV).

When to see a doctor
Generally, see your doctor if you experience any unexplained dizziness or vertigo that recurs periodically for more than one week. Although it's uncommon for dizziness to signal a serious illness, see your doctor immediately if you experience dizziness or vertigo along with any of the following:

• A new, different or severe headache
• A fever of 101 F (38 C) or higher
• Double vision or loss of vision
• Hearing loss
• Trouble speaking
• Leg or arm weakness
• Loss of consciousness
• Falling or difficulty walking
• Numbness or tingling
• Chest pain, or rapid or slow heart rate

The signs and symptoms listed above may signal a more serious problem, such as stroke or a cardiac condition.

Causes

About half the time, doctors can't find a specific cause for BPPV.

When a cause can be determined, BPPV is often associated with a minor to severe blow to your head. Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or during prolonged positioning on your back.

The ear's role
Inside your ear is a tiny organ called the vestibular labyrinth. It includes three loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head. Other structures (otolith organs) in your ear monitor movements of your head — up and down, right and left, back and forth — and your head's position related to gravity. These otolith organs — the utricle and saccule — contain crystals that make you sensitive to movement and gravity.

For a variety of reasons, these crystals can become dislodged. When they become dislodged, they can move into one of the semicircular canals — especially while you're lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to. As a result, you feel dizzy.

Risk factors

Benign paroxysmal positional vertigo occurs most often in people age 60 and older but can occur at any age. Aside from aging, there are no definite factors that may increase your risk of benign paroxysmal positional vertigo. However, a prior head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Complications

Although benign paroxysmal positional vertigo (BPPV) is uncomfortable, it rarely causes complications. In rare cases, if severe, persistent BPPV causes you to vomit frequently, you may be at risk of dehydration

Make an appointment with your doctor if you have symptoms that are common to BPPV. After an initial examination, your doctor may refer you to an ear, nose and throat (ENT) specialist or a doctor who specializes in the brain and nervous system (neurologist).

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Write down your symptoms, including when they started and how often they occur.
• Note any recent blows to your head, including even minor accidents or injuries.
• Make a list of your key medical information, including any other conditions for which you're being treated and the names of any medications, vitamins or supplements you're taking.
• Take a family member or friend along, if possible. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Questions to ask the doctor at the initial appointment include:

• What are the possible causes of my symptoms or condition?
• What tests do you recommend?
• If these tests don't pinpoint the cause of my symptoms, what additional tests might I need?
• Do I need to follow any restrictions while we're seeking a diagnosis?
• Should I see a specialist?

Questions to ask if you are referred to a specialist include:

• What is my diagnosis?
• What treatments are most likely to help me feel better?
• How soon after beginning treatment should my symptoms start to improve?
• If the first treatment doesn't work, what will you recommend next?
• Am I a candidate for surgery? Why or why not?
• What self-care steps can help me manage this condition?
• Do I need to follow any activity restrictions? For how long?
• Am I at risk of this problem recurring?
• How often will you see me for follow-up visits?
• I have these other health conditions. How can I best manage them together?
• What handouts or websites do you recommend for learning more about BPPV?

If any additional questions occur to you during your medical appointments, don't hesitate to ask.

What to expect from your doctor
A doctor who sees you for symptoms common to BPPV may ask a number of questions, such as:

• What are your symptoms, and when did you first notice them?
• Do your symptoms come and go? How often?
• When symptoms occur, how long do they last?
• Is one or both of your ears affected?
• Does anything in particular seem to trigger your symptoms, such as certain types of movement or activity?
• Do your symptoms include vision problems?
• Do your symptoms include nausea or vomiting?
• Do your symptoms include headache?
• Have you lost any hearing?
• Have you had any weakness, numbness or tingling in your arms or your legs?
• Have you had any difficulty talking or walking?
• Have you had chest pain?
• Are you being treated for any other medical conditions?
• What medications are you currently taking, including over-the-counter and prescription drugs as well as vitamins and supplements?

Tests and diagnosis

Your doctor may do a series of tests to determine the cause of your dizziness. During a physical examination, your doctor will likely look for:

• Signs and symptoms of dizziness that are prompted by eye or head movements and then decrease in less than one minute
• Dizziness with specific eye movements that occur when you lie on your back with your head turned to one side and tipped slightly over the edge of the examination bed
• Involuntary movements of your eyes from side to side (nystagmus)
• Inability to control your eye movements

If the cause of your signs and symptoms is difficult to diagnose, your doctor may order additional testing, such as:

• Electronystagmography (ENG) or videonystagmography (VNG).The purpose of this test is to detect abnormal eye movement. ENG (which uses electrodes) or VNG (which uses small cameras) can help determine if dizziness is due to inner ear disease by measuring involuntary eye movements while your head is placed in different positions or your balance organs are stimulated with water or air. Other tests can assess your ability to maintain an upright position under easy and difficult conditions.
• Magnetic resonance imaging (MRI). This technique uses a magnetic field and radio waves to create cross-sectional images of your head and body. Your doctor can use these images to identify and diagnose a range of conditions. MRI may be performed to rule out acoustic neuroma — a noncancerous brain tumor of the nerve that carries sound and balance information from the inner ear to the brain — or other lesions that may be the cause of vertigo.

To help relieve benign paroxysmal positional vertigo (BPPV), your doctor, audiologist or physical therapist may treat you with a series of movements known as the canalith repositioning procedure.

Canalith repositioning
Performed in your doctor's office, the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head. The goal is to move particles from the fluid-filled semicircular canals of your inner ear into a tiny bag-like open area (vestibule) that houses one of the otolith organs (utricle) in your ear where these particles don't cause trouble and are more easily reabsorbed. Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure is usually effective after one or two treatments.

After the procedure, you must avoid lying flat or placing the treated ear below shoulder level for the rest of that day. For the first night following the procedure, you should elevate your head on a few pillows when you sleep. This allows time for the particles floating in your labyrinth to settle into your vestibule and be reabsorbed by the fluids in your inner ear.

On the morning after your in-office procedure, your restrictions will be lifted and you'll begin self-care as directed by your doctor. Your doctor likely will have taught you how to perform the canalith repositioning procedure on yourself so that you can do it at home before returning to the office for a recheck.

Surgical alternative
In rare situations in which the canalith repositioning procedure isn't effective, your doctor may recommend a surgical procedure in which a bone plug is used to block the portion of your inner ear that's causing dizziness. The plug prevents the semicircular canal in your ear from being able to respond to particle movements or head movements in general. This success rate for canal plugging surgery is greater than 90 percent.

home remedies

If you experience dizziness associated with benign paroxysmal positional vertigo (BPPV), consider these tips:

• Be aware of the possibility of losing your balance, which can lead to falling and serious injury.
• Sit down immediately when you feel dizzy.
• Use good lighting if you get up at night.
• Walk with a cane for stability, if you are at risk of a fall.
• Work closely with your doctor to manage your symptoms effectively.

BPPV may recur even after successful therapy. Fortunately, although there's no cure, the condition can be managed with physical therapy and home treatments.