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Monday, 17 January 2011

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Health Watch

Eating junk food and preaching nutrition

Recently a very funny incident took place after a seminar organized by the Non Communicable Diseases Unit of the Health Ministry. That is serving short eats/junk food to Health Minister Maithripala Sirisena after holding a seminar.

Minister Sirisena stressed the doctors that they need to follow what they preach to the public and need to set examples for the ordinary people. The Minister pointed out that having tea at 10.30 am after taking breakfast at 8.30 am is something not healthy. This is something that is done by many of us almost every day in our lives. At least we do it few times a week, especially during working days.

If you are working in a office, you take breakfast at 8 or 8.30 am. This is the usual time for breakfast for many office workers no matter whether they belong to low or high ranks.

Most of the office workers finish their breakfast by 9 am. Here comes the conference/meeting time! The majority of the office staff take part in some sort of official/formal meeting/discussion/conference during this time. Then comes the tea break or coffee break!

Although the tummy is full with the heavy breakfast taken just one and half hours ago, the crowd has the snack and tea laid out. It is a big relief for them after filling their heads with more work and responsibilities given to them during the meeting!

Tea or coffee break is not something bad. The scheduling of it and the food served during tea time is somewhat bad when it comes to health. Usually there is a huge gap between the tea break and the lunch break in Sri Lanka.

Tea break comes on or before 10.30 am but the lunch time comes only after 1 or 1.30 pm. During the tea break, usually, typical Sri Lankans eat short eats or some other sort of junk food. They do not eat a little but an amount similar to another mini breakfast!


Tea time snacks

Normally the lunch time falls between 12 noon and 1 pm but people who don’t feel hungry skip lunch during this time. Therefore the cafeterias and all the other eating houses get busy after 1 or 1.30 pm. What is the point of eating too much food in the first half of the day and starving during the second half of the day? Why can’t we have food when we feel hungry or when the body asks for it? Who set the tea or coffee time? Most of the Sri Lankans starve till they take breakfast. This is a well know fact and this problem exists especially among school children in Sri Lanka.

Most of the school children leave home early in the morning (around 5.30 or 6.00 am) without having anything for the breakfast.

Some of them just have a cup of milk. Some go to school and have a `breakfast’ from the cafeteria. Sometimes it is just junk food or fast food. Other children do not have breakfast at all. The meaning is some school children starve for 2 hours before breakfast and some school children starve for five hours or so till the school interval.

During the interval, they eat some short eats or some other junk food given by their lazy/ignorant/high class mothers or the fast food outlet adjoining to the school!

According to the latest statistics of the Health Ministry, the country has only 20 million people but annually 45 million people obtain treatment from OPDs of state hospitals. A large number of people receive in-house treatment. Forty Sri Lankans die daily from strokes and 150 persons die from heart attacks. Around 350 persons die from NCDs. Around 12 percent of the national income represent the money from selling liquor but 22 percent of that income is spent on NCDs.

NCDs are on the rise in Sri Lanka. Food plays a major role in increasing NCDs among the people. Mothers are responsible for food when it comes to feeding children and each individual holds the responsibility for what he/she eats.

Therefore, having or not having tea at 10.30 am is up to you. The best practice to follow is eat only when you feel hungry and eat something and not everything that is made available. The amount depends on how hungry you are and the varieties depend on the health issue you have such as diabetes, high blood pressure and so on.

So eat what you want, when you need not when the tea/coffee break comes!


Ear infections:

Early antibiotic treatment provides better success

While antibiotics have become over-prescribed and are often misused, leading to a rise in antibiotic resistance, there is compelling evidence that providing early antibiotic treatment to children with ear infections (otitis media) significantly raises the success for a quick resolution.


Having a daily checkup

A multicenter US trial showed that children who were treated with antibiotics at the onset of otitis media had “more durable symptom resolution” and a 70 percent to 80 percent lower rate of clinical failure compared to children who with observation. A better outcome was slightly tainted by the higher rate of diarrhea experienced by those taking the antibiotics.

“The benefit must be weighed against concern not only about the side effects of the medication but also about the contribution of antimicrobial treatment to the emergence of bacterial resistance,” Children’s Hospital of Pittsburgh MD Alejandro Hoberman, and co-authors wrote in today’s New England Journal of Medicine.

Antibiotics are chemical substances derived from microorganisms like fungi and bacteria that is used to destroy or inhibit the growth of harmful microorganisms. The most common use is in the prevention and treatment of infectious diseases, though it can also be used to treat minor discomforts and aid in the healing of minor wounds. There are more than 100 different antibiotics available, but there are several main classes that include such well-known drugs as penicillin and tetracycline. Each one is effective for specific types of infections, as the bacteria that causes the infections vary.


Ear infeciton

European nations use the “watchful waiting” strategy in children with mild otitis media, utilizing antibiotics for severe or prolonged cases. While the American Academy of Pediatrics and the American Academy of Family Physicians have endorsed watchful waiting as an option for children 6 to 23 months of age who have non-severe illness, the general protocol in the US is still antibiotic therapy.

When it comes to proper antibiotic use, FDA recommends the following:

Don’t skip doses and take your medicine as prescribed. Antibiotics are most effective when taken as prescribed.

Don’t save antibiotics. The drug is meant for a particular infection at that time.

Don’t use leftover medicine. Taking the wrong drug can delay the appropriate treatment and your infection might get worse.

Don’t take antibiotics prescribed for others. Only a health care professional can determine the right treatment for your infection.

Health News


Gene tests do not cause distress

*People can handle results of consumer gene tests-study

* Tests did not cause people to change their lifestyles

Most people who used a commercially available genetic testing kit made by Navigenics were not traumatized by their results, as some critics had feared, US researchers said on Wednesday.


Genes

The results did not cause people to change their lifestyles through diet, exercise or other changes to reduce their risks either, said a team led by Dr Scripps Translational Science Institute in San Diego, Eric Topol of the whose study appears in the New England Journal of Medicine.

“They did no harm and it’s debatable about how much good they do,” Topol said of the tests in a telephone interview.

The study is the first to look at the impact of these tests, and the findings address concerns that consumer genetic tests could distress people who learn they are at risk for diseases like Alzheimer’s or diabetes.

In July, the US Food and Drug Administration said consumers may not know what to do with information from genetic tests taken without a doctor’s guidance.

None of the tests sold to consumers were approved by the FDA, but the agency said last summer it was gearing up to regulate them. Companies that make the tests include Navigenics Inc, Pathway Genomics Corp, and 23andMe Inc, which is backed by Google Inc.

“These tests have been harshly criticized by the medical community and Government agencies, but until now there were no data,” Topol said in a statement.

His team studied 2,000 adults who took the Navigenics Health Compass, which looks for genes that raise the risk of more than 20 conditions such as diabetes, obesity, heart attack and some forms of cancer.


DNA results

Participants filled out an online questionnaire before the test detailing their level of anxiety, exercise and eating habits as well as medical screening practices and other behaviors. They filled out another questionnaire five to six months after they got their results.

More than 90 percent of people who completed the follow-up questionnaire had no test-related distress.

And while companies that sell the tests often claim that they can help people make positive lifestyle changes, the team saw no evidence of that.

But Topol said many people in the study said they were thinking about getting a screening test.

About 10 percent of participants discussed their results with a genetic counselor which was offered for free and 26.5 percent said they shared their results with a doctor.

Chief executive Navigenics Dr Vance Vanier said the study shows direct-to-consumer genetic testing does not cause undue anxiety.

He was encouraged to find that 25 percent of people who shared the results with their doctors made lifestyle changes, suggesting the tests could be a tool for doctors to encourage healthy behaviors. The study did not look at whether the results were accurate or meaningful. A General Accounting Office probe in July found genetic tests sold by four different companies produced inconsistent results.

Navigenics provided the genetic tests, but had no other role in the study, which was funded by the National Institutes of Health.


Is water fattening?

Water has been the subject of a heated debate among those who believe it is fattening - in many cases, obese individuals - and those who say it isn’t. However, if we approach it logically, there is a third possibility: does water help to lose weight?

In this article, we will try to demonstrate the paths and actions of water in the human body. It does not contain calories, but the body would die in a few days in its total absence. It comprises close to two-thirds of our body weight, and in healthy people, there is a good balance between the water we take in and the water we expel.

How do we take in WATER?

We need an average of 2.5 litres of water daily. Sometimes our body asks for more, and should be given more, such as in cases of intense physical exercise, high environmental temperatures, fever, vomiting, diarrhoea and other symptoms.

As a very clear message to those who eat too much, we say that sometimes thirst is wrongly interpreted as hunger. In that case, one should begin by drinking a glass of water and once the thirst is sated, the tendency to eat too much is also reduced.

Healthy people should drink as much water as they want when thirsty, because the excess water is quickly and easily eliminated through our kidneys.

We take water in three different ways - drinking it as a liquid, consuming it as an element of solid foods and through our internal metabolism, as a part of processing proteins, fats and carbohydrates.

The foods rich in water, with 90 to 99 percent composition, include non-fat milk and skim milk, soda, melon, lettuce, tomato, asparagus, bell pepper, eggplant, cabbage and onion.

The ones with the least water are pasta, legumes, dried fruits, sugar, cookies, and chocolate, with a modest content of 1 to 9 percent water.

In the middle are semi-fatty meats, salmon, chicken breast, meatballs, baloney, pizza, cherries and semi-cured cheeses.

The only food completely free of water is oil

It is good news for those trying to lose weight that drinking more water helps, because it increases calorie-burning by the body as it is absorbed, distributed, metabolized and eliminated. We can also say it is the only nutrient that does not add a single calorie.

Eliminating water

The body has four ways of eliminating water and maintaining a healthy balance. The kidneys are the principal way by producing urine. For that reason, drinking too much water is not a problem for a healthy person-the excess is eliminated quickly and easily.

Sweat is the second way, but is very volatile, and depends on physical exercise and the environmental temperature. It may vary from 100 ml daily to one or two litres hourly in a very hot climate or with intense exercise.

Third is defecation, which usually accounts for a modest quantity of 100ml daily. This may increase when the quantity of dietary fibre is increased, requiring more water, which in turn benefits the entire process.

The fourth way water is eliminated is imperceptible losses that occur constantly in all living beings, representing 700ml daily. This includes through the skin, independently of sweat and evaporation through our breath. Extremely large amounts are lost, for example by burn victims.

Distribution and functions of water

If you are an average, normal adult weighing approximately 154 pounds (70 kg), it is good to know that your body holds no less than 42 litres of water, representing 60 percent of your weight.

Body liquid is distributed in two compartments. The 75 billion cells of our body hold 40 percent of total body weight (about 28 litres) - and it is called intracellular liquid. The rest, which is extra-cellular, is distributed in the spaces between the cells, in our blood plasma and in the liquids found in our joints, membranes and brain.

Water is involved in many body functions, and is felt in all chemical reactions. It is also the vehicle for transporting nutrients to all our cells, and for taking away waste to be eliminated. It also lubricates and provides structural support for tissue and joints, and plays an extremely important role in regulating body temperature.

To answer the question in this article’s headline, we can categorically say that water is not fattening, and in every case contributes to reducing body weight, because its processing alone makes the body burn calories. We can also say that normal individuals should not experience water retention, given the body’s natural balance between what is consumed and what is expelled. One final piece of advice: when thirsty, drink all the water you want.

Professor of Medicine and Chief of Endocrinology Services Teaching Hospital, Havana, Cuba Dr Salvador Allende

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