For many years indigestion has been considered the number one disturbance of American businessmen. Irvin Cobb told the story of the dyspeptic who hears the noon whistle: “Twelve o’clock,” he says. “I’m going home. If lunch isn’t ready, I’m going to raise Cain. If it is ready, I won’t eat a bite.” Heartburn, the belching of sour material, nausea, vomiting, a feeling of fullness or pressure, are the symptoms that trouble most.
While the symptoms listed may be relatively insignificant as far as any serious disease is concerned, the difficulty for both doctor and patient lies in the fact that the same symptoms in varying degree may be associated with exceedingly serious disorders. The severity of pain varies from one person to another, and the agony of the pain is not really a measure of the condition that is wrong. Most people digest their food and move the residue along towards elimination without much attention to what is going on. If the symptoms that have been mentioned come on one or two hours after eating, they may be due to uncomplicated ulcer of the stomach or duodenum and the doctor will have to make extra studies, including use of the X-ray to be sure of the diagnosis. Similar symptoms may occur in conditions related to the appendix or the gall bladder, or to blocking of the passage of the food, or to a weakness in the diaphragm, the large muscle of breathing which separates the abdomen from the chest.
Indigestion may, moreover, be associated with psychological problems, excessive use or abuse of tobacco, coffee, or alcohol, rapid eating with insufficient chewing, constipation with the cathartic habit, and many other errors of digestive hygiene.
When there is sensitivity or allergy to certain food substances, eating of such foods may arouse gastrointestinal distress.
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Diabetes is a disease in which people cannot metabolize carbohydrates because the pancreas will not secrete insulin, the hormone which regulates the metabolism of blood sugar. It is thought that the disease is hereditary. Haifa per cent of children suffer from diabetes mellitus and the onset is usually sudden and severe. The child or adolescent loses weight, gets hungry and thirsty constantly, urinates frequently and has a dry and itchy skin. Treatment is essential as the final outcome could be diabetic coma.
The 2 types of diabetes mellitus are insulin independent and insulin dependent. It is the latter which tends to occur in adolescents and it is sometimes called juvenile onset diabetes. Sufferers depend on insulin injections and must be under the care of a medical practitioner.
Research has shown that vitamin and mineral supplementation can help sufferers. Chromium is a component of the glucose tolerance factor (GTF) and it increases tolerance in animals, boosting the effectiveness of insulin. It is found in brewer’s yeast. A high fibre, high complex carbohydrate diet including foods such as cereal grains, especially rolled oats, root vegetables and legumes is important. Avoid any refined sugars. Complex carbohydrates should be 75 per cent of the diet, protein 15 to 20 per cent, and fat 5 to 10 per cent. Clinical studies have found that zinc is excreted in the urine by diabetics. A zinc supplement may be useful.
Clinical studies have also shown that vitamin С improved glucose tolerance in patients given 500mg daily. Supplementation may be useful but if your child is supplementing with vitamin С it may alter the results of urine tests. Talk this over with your medical practitioner who must also be supervising the disease.
Supplements
Brewer’s yeast for children over 12 years 500mg twice daily
Vitamin С l,000mg daily
Zinc 25mg daily
Vitamin E l00 IU daily
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Diabetes occurs when the body is unable to fully metabolize sugars and starches, either because the pancreas doesn’t produce enough insulin for processing, or the insulin produced is less than effective.
In mild cases, diet alone can control the condition. In severe cases, replacement insulin is necessary. In all cases, the care of a physician is essential – but that doesn’t mean you have to give up on your get-up-and-go!
Energize Your Eating
• Keep your diet low in fats and high in complex carbohydrates, especially those that are rich in fibre, such as whole grains and dried beans.
• Avoid all foods containing refined sugars.
• Have 4-6 small meals daily instead of 2-3 large ones.
• Eat more fish. It’s high in protein and low in fat.
• Increase raw fruits and vegetables in your diet.
• Add brewer’s yeast to meals when you can – especially if you’re a senior citizen. (Impaired glucose tolerance is a definite factor in maturity-onset diabetes, and brewer’s yeast is a prime source of GTF, the glucose tolerance factor which can potentiate insulin.)
• Make sure your meals contain plenty of vitamin E- and C-rich foods. These will help counteract the poor circulation and impeded blood vessels that diabetics are prone to.
• Drink a cup of freshly made raspberry tea 2-3 times daily (steep leaves in hot water for half an hour). It’s one of the best herbal remedies for lowering blood sugar.
Suggested Supplements
• GTF chromium, 50 mcg., 3 times daily
• Potassium, 99 mg., 3 times daily
• Chelated zinc, 50 mg., 1-3 times daily
• Water, 6-8 glasses daily
And don’t forget exercise!
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High blood pressure may increase the thickness of heart muscle and reduce coronary circulation.
• What is the normal blood pressure?
Blood pressure is measured with two readings, systolic and diastolic and the measurement is mm Hg.
Blood Pressure Systolic/Diastolic (mm Hg)
Normal Blood Pressure 120/80
High Normal 130-139/85-89
Stage I Hypertension 140-159/90-99
Stage II and III >160/>100
To control the blood pressure, one needs to follow certain life style modifications like diet, exercise, yoga and meditation, however in stages I – III one may need drug therapy along with lifestyle measures, depending upon the other risk factors involved. Maintenance of weight with low-fat diet and salt restriction is mandatory. Other factors that could play role in hypertension are excessive sodium, saturated fats, coffee, diet low in potassium and calcium. The studies have shown that salt restriction is important to lower the blood pressure, and for patients with hypertension lowering of dietary salt is very important.
DASH Diet (Dietary approaches to stop hypertension)
Blood pressure reduces with diet low in total fat, low saturated fat, low cholesterol, and low-fat milk and milk products, and rich in fruits and vegetables. So DASH diet includes, whole grains, fish, nuts, vegetables and fruits. DASH diet has reduced amounts of fat, red meat, sweets, refined carbohydrates, sugared beverages. It is rich in potassium, calcium, magnesium, proteins and fibre. Studies have shown that lower the sodium, lower is the blood pressure.
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Cardiovascular diseases account for an appreciable proportion of total morbidity and mortality in adults throughout the world. Nutritional factors play an important and parallel role in the etiology and management along with some environmental factors like physical exercise, cigarette smoking, tobacco chewing and type of personality. Other factors associated, of course, are family history, overweight, hypertension, diabetes and stress of life.
Incidence of obesity, diabetes and CVD is increasing and at present obesity is present in 14% of rural population and 27% of urban population, as urban population is more prosperous and sedentary, along with refined food eating patterns. Hypertension (high blood pressure) is 5% in rural population and 5-15% in urban population. Diabetes is 7-12% and heart disease is 6-10% and all these conditions are interrelated.
Risk Factors
1. Family history
People who already have the disease in their family are more prone to getting heart disease.
2. Obesity
Obesity or excessive weight is the primary cause of most of the illnesses, it has a major role to play in heart disease. Obese people or overweight people are more prone to heart disease. There is no clear definition of desirable or ideal body weight, however, a simple way of finding out is the ratio of weight and height termed body mass index (BMI); weight in kg and height in m2
People who have their BMI between 23 and 25 are called overweight and all those who have their BMI>25 are called obese. Normal BMI being between 18.5 and 23.
More than the general accumulation, distribution of fat around the abdomen is considered more harmful than the fat on the hips, therefore waist/hip ratio (WHR) is a better predictor of chronic diseases. Normal WHR is 0.85 for female and 0.90 for males, waist has be measured at the naval point and hips at the maximum level.
3. Hypertension or high blood pressure
Is also a risk factor. Coronary heart disease (CHD) has a striking relationship with systolic and diastolic blood pressure and reduction of weight and alcohol can lower blood pressure.
4. Diabetes
Diabetics are more prone to CVD as compared to non-diabetics, therefore, it is important for all diabetics to keep their sugar under good control so that they can delay or prevent getting coronary artery disease.
5. Age
Age is also a factor and men >45 years and women >55 years are more prone to getting a coronary disease.
6. Smoking and tobacco
Cigarette smoking and tobacco chewing are both bad. Tobacco is injurious to heart and health in all forms, whether in chewable or non-chewable such as cigarette or cigars. Coronary artery disease has been seen in 80% of the smokers. Inhaling nicotine, carbon monoxide and various other pollutants narrow the coronary arteries, thus reducing the blood flow to the heart muscle.
7. Lack of physical activity
Sedentary and unexercised people are more prone to CVD. Physical activity or exercise is a recommendation.
8. Blood lipids or fats in the blood
• The risk is more when
Plasma total cholesterol > 200 mg/dl
Plasma HDL cholesterol < 35/dl
Plasma LDL cholesterol > 135 mg/dl
With CVD
• Plasma TG > 150 mg/dl
• Total cholesterol: HDL ratio > 5
• Elevated homocysteine levels
These are the levels beyond which the risk factor increases.
9. What is blood cholesterol?
High cholesterol is a serious problem for heart disease. The higher the blood cholesterol, the greater is the risk of getting the heart disease. Blood cholesterol has different fractions; one is called low density lipoprotein (LDL), the bad cholesterol and the other is called the higher density lipoprotein (HDL), the good cholesterol. LDL gets deposited in the arteries, therefore more the LDL in the blood, greater is the risk of heart disease. On the other hand, HDL the good cholesterol helps us to get rid of the bad cholesterol, so higher the HDL better it is. Similarly, we also have triglycerides (TG) in the blood, which is also a risk factor just like cholesterol.
Factors you can control Factors you cannot control
1. Cigarette smoking Age (55 years for men and 45 years for women)
2. High blood cholesterol Family history of early heart disease (heart attack or
especially LDL sudden death)
3. Low HDL Heredity.
4. High blood pressure
5. Diabetes
6. Obesity/overweight
7. Physical activity.
10. Dyslipidaemia
Elevated serum cholesterol and triglycerides are the strongest risk factors of CVD. When the person has blood lipid levels more than the mentioned limit, it is termed dyslipidaemia.
The cholesterol lowering will reduce the major risk of coronary event. Treatment of dyslipidaemia is mandatory for primary and secondary prevention of CVD.
11. Hypertriglyceridaemia
High triglycerides in the blood are termed hypertriglyceridaemia.
12. Apolipoprotein (A)
The factor in combination with low levels of HDL and elevated triglycerides results in the formation of small dense LDL, which increases the risk of CVD.
13. Elevated homocysteine
Having high homocysteine in blood is also a risk factor for CVD.
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INHALED IRRITANTS ARE substances that cause narrowing of the airways but don’t seem to bring on inflammation in the bronchi. The most important of them are secondary cigarette smoke and air pollutants.
Cigarette Smoke. For a child whose asthma is sensitive to cigarette smoke, this situation can be a problem. Some families tackle the problem by prohibiting smoking inside the home allowing cigarette smoking only in certain rooms and not in the room where the child may be. It is possible that sometimes visiting relatives or friends may not understand that cigarette smoke bothers the child. This can be a problem. These individuals may have to be told firmly that snaking aggravates the child’s illness and they should not smoke indoors. The child may have to practise ways of asking adults to stop smoking, or may leave the room until the smoke clears away. Parents may install room air purifiers or put up signs that say: Thank you for not smoking.
Medical evidence shows that exposure to secondary tobacco smoke increases the risk of respiratory illness in children. A study evaluated five families and their asthmatic children, aged 5-14 years, in an outpatient counseling programme for reducing the children’s exposure to passive smoking. Intervention included biweekly counselling and instructions to parents to limit their child’s exposure to tobacco. Counselling was associated with smoke exposure reduction of 40-80 per cent from baseline for each of the five children, with most improvements sustained during follow-up. This study was helpful in the development of tobacco exposure prevention programme for children with pulmonary disease.
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For many years, osteoarthritis has been called the “arthritis of wear and tear”. This view has come to be challenged and now osteoarthritis is better known as a disorder of cartilage repair. Furthermore, the predisposition to osteoarthritis seems to run in families. As a result, medical scientists have begun to search for a genetic predisposition to this common disabling condition.
Osteoarthritis begins to cause pain and disability when the cartilage lining a joint cavity wears through and fails to repair. Cartilage acts as the joints Teflon lining. In association with joint fluid, cartilage produces 200 times less friction than ice sliding on ice. When the cartilage is gone – bone rubs on bone. This action is like the broken end of two dry twigs being rubbed determinedly together. It is no wonder people with osteoarthritis suffer from incapacitating pain.
Arthritis tablets Ike Aspirin (NSAIDS) have a controversial role to play in the treatment and progression of osteoarthritis. These drugs suppress the action of prostaglandins which mediate the production of stiffness, swelling and pain. They do nothing to correct the underlying disorder of cartilage which lies at the heart of the osteoarthritis conundrum
The manufactures of Feldene, a long acting NSAID, are quick to point out that the products of many other drug companies actually accelerate the process of cartilage decay.
In the final analysis, it doesn’t matter which drug is used to relieve the pain of osteoarthritis. The condition gets worse whenever weight bearing activity continues. The more medication denies a joint the protection of painful stimuli; the sooner the damage gets worse.
Given the further propensity of NSAIDS to cause peptic ulceration and bleeding, people are advised to avoid this group of drugs whenever it becomes humanly possible. Some arthritics are so handicapped by swelling and pain that they have little choice. They take their chances with bleeding and the NSAIDS; rather than suffer the pain.
Home Remedies
In spite of the fact that continued usage accelerates the destruction of an osteoarthritic joint; immobilization is not the answer. Without mobilization, an arthritic joint rapidly loses its function. Arthritis Foundations in all states provide a wealth of advice and treatment aids that cannot be surpassed by your local medical practitioner. Get in touch with your local branch at the earliest opportunity. There is something very relaxing and relieving about emersing painful joints in warm water. The reduction of weight bearing and exercises in warm water has allowed hydrotherapy to stand the test of time. Don’t forget the services of your friendly physiotherapist. They too have more to offer than the pernicious pills, potions and poisons of your prescribing medical practitioner.
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An exciting recent development with evening primrose oil has been with rheumatoid arthritis. Evening primrose oil may help many patients reduce their dose of non-steroidal anti-inflammatory drugs, or give them up altogether.
A study was done at Glasgow Royal Infirmary with 49 patients with rheumatoid arthritis.’ Sixteen of these patients were given evening primrose oil (Efamol), 15 were given a combination of evening primrose oil and fish oil (Efamol Marine), and 18 patients a placebo (liquid paraffin.)
The aim of the study was to find out whether evening primrose oil or evening primrose oil combined with fish oil could replace the conventional non-steroidal anti-inflammatory drug (NSAID) treatment in rheumatoid arthritis.
The study lasted 15 months altogether. The initial 12 month treatment period was followed by three months of placebo for all groups. The dose was 12 capsules, usually taken as 3 capsules four times a day. No one knew what they were taking as all the capsules looked identical.
At the end of 12 months, results showed a significant subjective improvement for the Efamol and the Efamol Marine group, compared with the placebo group. Moreover, by 12 months the patients on Efamol and Efamol Marine had significantly reduced their NSAIDs. And despite this decrease in drugs, the disease did not get worse.
Sixty per cent of the patients on the Efamol alone were able to stop taking drugs, and a further 25% were able to halve the dose without ill effects.
The most consistent results, though, were for the Efamol Marine group. In this group, 60% were able to stop taking their anti-inflammatory drugs altogether, while 35% halved their dose. However, the amount of subjective improvement in the Efamol alone group was often greater than in the Efamol Marine group.
It was clear from this study that the evening primrose oil, or combination of oils, was the therapeutic anti-inflammatory agent. When the treatment group was switched to placebo for the last three months of the trial, all but one of the patients suffered a relapse.
The conclusion of this important study is that evening primrose oil and evening primrose oil with fish oils produce a subjective improvement in rheumatoid arthritis, and allow some patients to reduce or stop treatment with conventional anti-inflammatory drugs.
However, as yet there is no evidence that they act as agents which actually modify the disease.
The patients who had been taking evening primrose oil or evening primrose oil combined with fish oils experienced subjective improvements in their conditions, and felt a greater sense of well-being. However, the doctors working on this study were not able to measure any objective improvements.
All the patients in the Glasgow trial had a fairly mild form of rheumatoid arthritis. The results of this particular trial were much better than some previous ones in which a lower dose of evening primrose oil was given for a shorter period of time on more severely disabled patients.
The doctors conducting this study felt that, as those patients on the Efamol and the Efamol Marine treatment were able to decrease or stop their usual drugs, these oils can best be used in those cases where a patient cannot take NSAIDs because of conditions such as a peptic ulcer or renal impairment.
The great advantage of evening primrose oil for rheumatoid arthritis is that it is a natural product, without side-effects. In contrast to the NSAIDs, evening primrose oil has actually been shown to have a protective effect on the stomach.
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