A report by Swachh Bharat Mission says that 74.5 per cent of public places are equipped with toilets. Another report by the Ministry of Jal Shakti states that there are 2.23 lakh Community Sanitary Complexes built across all States and UTs under the Swachh Bharat Mission (SBM) since October 2014. Over 92 lakh toilets have been constructed since the launch of SBM Gramin (SBM (G)) in April 2020.

While toilets are there, are they accessible? This is the question one should ask. The National Family Health Survey (NFHS) focuses on 131 health indicators, but not until the NFHS 5 survey did they include the question of accessibility of toilets in the survey. This happened after the inputs from the Department of Drinking Water and Sanitation (DDWS) and the Ministry of Health & Family Welfare questioned the accessibility.

One might ask, why is the question of accessibility so important? The answer is quite simple. Access to water, sanitation and hygiene is the most basic human need and is also included under the Sustainable Development Goals by the UN.

Are These Numbers Real?

Just a few weeks back, I was travelling to Himachal Pradesh on a bus. While I was excited to explore the state for the first time, anxiousness gripped me. “What if I have to dehydrate myself again on the journey?” I thought.

This thought crossed my mind because back in 2021, I went on a solo trip, on a bus to Udaipur from Delhi. There, the bus made two stoppages. This was done so people could get a quick dinner and freshen up, relieve themselves and be prepared for the rest of the journey. This was a nightmare. The bus only stopped for 10 minutes. While some men used the washroom, others went to the bushes.

For the women, there were three cubicles. One of them was broken, and the other one did not have a light bulb, which meant only one was usable. There was a long queue for that cubicle, and time was short. There was no point in trying to find an isolated corner, because it was past midnight, in an unknown area.

I waited anxiously. When finally, my turn came, I saw an overused, dirty washroom. The toilet seat is in a horrible condition. I wanted to touch nothing there. But I had to pee. So, I used my mask to cover my nose from the odour, folded my pants so they did not touch the floor and squatted. It was quite a task to balance.

On my way back to Delhi, I made sure to not drink any water for over a 13-hour bus journey. I dehydrated myself so I did not have to use the washroom. When I did reach, I was severely dehydrated and was sick for three days.

I shared my experience with my friends only to realise that many women have faced the same. There are no washrooms for women.

A friend of mine told me that it is because these roads and dhabas are mainly designed to serve men. They are the ones who travel at night or are on the roads most of the time. As a result, the few women who do travel or are on the road suffer.

Health Risks Women Are Prone To

Holding your pee for too long can lead to many health risks. But peeing on a dirty seat may lead to infections.

Well, it is true, but partially. While holding your pee for too long can lead to health risks, peeing on a dirty toilet seat cannot lead to infections unless your urethra is in contact with the bacteria present on that toilet seat. However, nobody wants to sit on a dirty toilet seat, even if you do not get an infection. A safe and hygienic toilet is a basic need.

One of the regular saleswomen, Usha, who visits my house shared her experience with me. “Being on the road constantly means I must use the dirty public washrooms. But I do not want to use them. So, sometimes I ask my regular customers to let me use their washrooms. Some say yes, and some say no. I understand they are also concerned about their safety and privacy,” she says. As a result, Usha spends most of her day not drinking enough water and holding her pee when she is at work. Due to this, she also suffered from a Urinary Tract Infection (UTI).

Her friend, Halima too faced similar problems and due to increased levels of uric acid in her body, she suffered from Hyperuricemia.

Other health risks are kidney stones and other kidney problems, headaches, dull skin, xerostomia or dry mouth, fatigue, and urinary incontinence, which means losing control over your pelvic floor muscles leading to uncontrolled leakage of urine, seizures and weakness.

What Can You Do?

I learned my lesson from Udaipur and for this trip, I did not want to be sick. So, there are a few essentials that I carried this time with me, that you can too. Because not drinking water or holding your pee is not the solution.

Wear comfortable clothes and capris. Capri pants are comfortable and are short in length, which means this won’t touch the toilet floor when you squat or sit.

Carry Essentials

I now carry a stand and pee device. With this device, you no longer must sit on the dirty toilet seat. It is a slanted funnel-like device, which can be placed between your legs when you urinate. Once you are done, you can dispose of it and throw the device in the dustbin.

Even though you cannot get a UTI alone from sitting on a toilet seat, it is always safe to carry a toilet seat sanitiser. If nothing, it can help you get rid of the bad odour so you can use your stand and pee device inside the toilet. You can also use disposable toilet seat covers if your knees are weak, and you cannot squat. Always flush with your seat down.

Always keep disposable gloves, a portable bidet (fill it with water before use), a pocket liquid handwash, wet wipes, tissues and sanitiser handy. Do not forget to keep extra sanitary pads. It might sound a lot, but I promise that it all fits in one pouch. Use this travel-friendly pouch every time you are on the road, or using a public washroom.

What Can We Learn From Others?

Countries like South Korea, Japan, and China have incorporated technologies in their toilet to provide a safe experience. They have different water modes, and a button that will wipe your seat when pushed. There are buttons that change your toilet seat covers too.

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

Fasting for three hours before bed can significantly improve heart health and reduce the risk of coronary artery disease (CAD) as well as other chronic conditions, an Arteriosclerosis, Thrombosis, and Vascular Biology study suggests.

While many believe that diet plans such as intermittent fasting or time-restricted eating can help reduce their weight, researchers at Northwestern University have found that not eating three hours before going to sleep can reduce overnight blood pressure by nearly four percent, heart rate by five percent and strengthen overall heart rhythms.

This can help reduce overall strain on the heart which lowers risks for conditions like hypertension and CAD. Additionally, the scientists also discovered a drop in blood sugar levels, improved glucose tolerance and insulin sensitivity.

Participants who underwent glucose tests also showed better insulin release which tend to stabilize during the day. Additionally, an improved heart rate also lowered nighttime cortisol, which helped in metabolic balance.

Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine and chief of sleep medicine in the department of neurology at Feinberg and corresponding author said of the results: "It's not only how much and what you eat, but also when you eat relative to sleep that is important for the physiological benefits of time-restricted eating."

The study authors also noted: "Extending overnight fasting duration by three hours in alignment with sleep improved cardiometabolic health in middle-aged/older adults by strengthening coordination between circadian- and sleep-regulated autonomic and metabolic activity.

"This sleep-aligned time-restricted eating approach represents a novel, accessible lifestyle intervention with promising potential for improving cardiometabolic function."

Coronary Artery Disease: The Silent Killer

Despite being as a common heart disease, coronary artery disease (CAD) develops over years and has no clear signs and symptoms apart from a heart attack. The illness begins due to a buildup of fats, cholesterol and other substances known as plaque in and on the artery walls.

Over time, this can cause narrowing or blockage of the coronary arteries and block the supply of oxygen-rich blood to heart which can lead chest pain (angina), shortness of breath and ultimately, heart attacks.

Typically, those above the age of 45, having a biological family member with heart disease, lack of sleep, smoking, consuming saturated fats along with other autoimmune diseases such as lupus and rheumatoid arthritis can increase the risk of developing CAD.

Treatment options may include medicines and surgery. Eating a nutritious diet, getting regular exercise and not smoking can help also prevent CAD and the conditions that can cause it.

Nearly one in 10 Indian adults suffer from CAD and about two million people die from the disease annually. Apart from this, about 18 to 20 million American adults aged 20 and older are also affected about the disease.

Strokes: A Rising Crisis In India

Additionally, heart strokes are also one of the leading global health burdens, causing significant deaths and disability worldwide, including in India. Compared to Western countries, stroke also tends to occur at a younger age and is associated with a higher case fatality rate in the country.

One in seven stroke patients in India are young adults aged below 45 years, with hypertension leading as the major risk factor, according to a study by the Indian Council of Medical Research (ICMR).

The Global Burden of Disease Study 2021 identified hypertension, air pollution, tobacco smoking, high cholesterol, increased salt intake, and diabetes as the leading risk factors of stroke.

Incidence of stroke is increasing significantly in low- and middle-income countries (LMICs), especially in India, due to population growth, aging, and greater exposure to risk factors.

Often called the stress hormone, cortisol is produced by your adrenal glands, located on top of the kidneys. The hormone plays a critical role in keeping you healthy and maintaining your energy as well cardiovascular health.

Cortisol is a necessary tool for survival and naturally peaks in the morning to help you wake up and drop at night to help you sleep. While the body has a system in place to maintain hormone levels, issues arise when cortisol levels stay chronically high, meaning your body is constantly in "fight-or-flight" mode.

This can happen due to long-term stress, certain medical conditions (like Cushing’s Syndrome), or the prolonged use of steroid medications.

However, Dr Suman Agrawal, a renowned Oxford University certified nutritionist and qualified fitness expert has shared how "Shin-Kokyu”, a technique used by Japanese samurais before a battle exercise can help reduce cortisol by 80 percent

Step One: Box breathing method:

• Inhale for four seconds through the nose while the tongue touches the palate
• Hold for four seconds with abdominal muscle tension
• Exhale for four seconds through the mouth, lips pursed
• Pause for four seconds with complete relaxation

Step Two: Hara point

Place three fingers below the navel with medium force & hold throughout the breathing. There’s a cluster of vagus nerve endings there. It’s like a button in the body.

Step Three: Gaze into nowhere

Look straight ahead and defocus your gaze as if you are looking through a wall for three minutes. This time span is equal to 12 breathing cycles which is the minimum time needed to reboot the nervous system.

Symptoms Of High Cortisol Levels

When cortisol is elevated for a long time, the body’s systems get overwhelmed. Common symptoms include:

• Physical Changes: Rapid weight gain, particularly around the abdomen, face (moon face) and the back of the neck (buffalo hump).
• Skin Issues: Thinning skin, easy bruising, and pink or purple stretch marks on the abdomen or thighs.
• Muscle & Bone: Weakness in the arms and thighs, muscle loss and an increased risk of bone fractures (osteoporosis).
• Metabolic Signs: High blood pressure, high blood sugar and a strong craving for sugary or fatty foods.
• Emotional & Cognitive: Persistent anxiety, irritability, mood swings, depression, brain fog and difficulty concentrating.
• Sleep & Energy: Chronic fatigue, feeling tired even after a full night's sleep and insomnia.

Health Risks of Chronic High Levels

If high cortisol levels are left un-addressed for an extended period, they can lead to serious health complications, including:

• Cardiovascular Disease: Chronic hypertension and damage to blood vessels increase the risk of heart attack and stroke.
• Type 2 Diabetes: Persistent spikes in blood sugar make it difficult for the body to manage insulin effectively.
• Suppressed Immune System: Chronic cortisol elevation can weaken immune response, making the body more susceptible to infections and slowing down wound healing.
• Mental Health Disorders: Long-term exposure is strongly linked to chronic anxiety and major depressive disorders.
• Digestive Issues: It can disrupt gut health, exacerbating conditions like IBS, bloating, and indigestion.

In a world fascinated by trendy superfoods, many traditional and nutrient-rich foods have been overlooked despite offering remarkable health benefits. From ancient grains, pulses to sprouts, these foods provide essential vitamins, minerals, protein and bioactive compounds that support digestion, immunity, bone health, and overall wellbeing.

However while many are aware of the benefits of fruits such as blueberries and grains such as oats, here are some important superfoods you need to incorporate in your diet:

1. Quark/ Curd

Quark, a German word for curd, has many benefits including being protein-rich which helps with muscle maintenance and repair, making it especially useful for older adults at risk of age-related muscle loss, known as sarcopenia.

The milk-based item is also low in calories and fat, providing nutrients without excess energy which also helps with weight management.

Apart from this, quark aids in gut health as it has same digestive bacteria as yogurt also known as probiotics. Probiotics are beneficial as they increase good bacteria in the intestine while keeping check on harmful bacteria. Moreover, they also helps absorb vitamins and minerals better.

Another benefit of consuming quark regularly is its high calcium content that is essential for supporting bone and teeth health such as preventing conditions like osteoporosis.

2. Prunes

Prunes are highly beneficial for digestive health as they are rich in fiber and contain sorbitol, a natural sugar alcohol that helps the gut absorb water and acts as a gentle, natural laxative.

They are also packed with protective plant compounds called polyphenols which function as antioxidants to reduce oxidative stress, lower inflammation and support overall cellular health.

Regular prune consumption can also help maintain bone mineral density, particularly in postmenopausal women by reducing the risk of osteoporosis. In addition, prunes provide important vitamins and minerals, including potassium, magnesium, copper, and Vitamin K, all of which support heart function, strengthen bones and assist enzymatic processes in the body.

Despite their sweetness, prunes are known to have a low glycemic effect due to sorbitol. This allows them to lower glycemic sugar levels in the body and increases overall blood sugar at a lower rate than other fruits, making it a safe option for diabetic patients to consume.

3. Blackcurrants

Blackcurrants are an exceptional source of Vitamin C, especially higher than oranges, and can support immune function, the body's fight against infections and aids in collagen production to maintain skin elasticity as well prevent scurvy, bleeding gums, fatigue and joint pain.

They are also rich in antioxidants called anthocyanins, which help neutralize free radicals, reduce oxidative stress and potentially lower the risk of chronic heart as well as gut-related diseases. The polyphenols in blackcurrants contribute to vascular health by improving blood vessel function and maintain healthy blood pressure.

In addition, blackcurrants are a good source of potassium, which is essential for heart muscle contraction and maintaining fluid balance. Additionally, the whole fruit provides fiber, which aids digestion, blood sugar control and cholesterol management.

4. Sprouts

Harvested at the plant’s most concentrated growth phase, sprouts pack high levels of bioactive compounds, known to be crucial in removing harmful toxins and reducing overall chronic inflammation.

Moreover, broccoli sprouts are rich in glucoraphanin, which the body converts to sulforaphane, a sulfur-containing compound that supports the liver's process of detoxification and has anti-inflammatory properties

Sprouts also provide a concentrated source of vitamins, minerals and antioxidants in a small, versatile form, making them easy to incorporate into meals. They can be eaten raw for full nutrient absorption or cooked thoroughly to minimize the risk of food-borne illnesses such as salmonella or E. coli.

While the vegetable is beneficial for most people, pregnant women, elderly and immuno-compromised individuals should avoid raw sprouts due to higher infection risk.

5. Liver

Called “nature’s multivitamin,” liver is known to be packed with high-quality protein, iron, and B Vitamins, making it a valuable source of essential nutrients.

It is also rich in Vitamin A and iron, which supports vision, immune function and cell growth and prevents iron deficiency, a common issue among menstruating women.

Liver also provides a concentrated source of other nutrients, especially B12, B6, riboflavin, folate which are important for energy metabolism, red blood cell production and nervous system health. Experts recommend consuming chicken liver to maximize on its benefits.

However, due to its very high Vitamin A content and purine levels, it should be consumed in moderation to avoid toxicity and prevent triggering conditions like gout.

6. Emmer

Emmer, an ancient form of wheat that retains its seed coat, is rich in fiber, vitamins, minerals and antioxidants as well as carbohydrates.

This allows it to support digestion, heart health and sustainable energy release, making it a valuable component of a balanced diet. Given its nutty flavor, emmer can be used as a substitute for rice or couscous, helping to diversify meals and supporting overall health and metabolic balance.

7. Peas

Peas, especially traditional varieties like carlin and marrowfat, are a good source of nutrients yet often overlooked despite sharing many of the same benefits as beans, a well-known top-tier superfood.

Carlin peas are rich in fiber and a good source of plant-based protein, supporting healthy digestion, blood sugar regulation, and muscle maintenance. They are also known to be versatile enough to include in snacks or meals.

On the other hand, marrowfat peas provide similar nutritional value and can be enjoyed in ways similar to avocado, a nutrient-dense superfood, adding both protein and fiber to the diet.