THE G.I. FACTOR AND DIABETES
We studied a group of people with diabetes and taught them how to alter their diet by substituting the high G.I. foods they were normally eating for carbohydrate foods with a low G.I. factor. After three months, there was a significant fall in their blood sugar levels. They did not find the diet at all difficult and in fact commented on how easy it had been to make the change and how much more variety had been introduced to their diet.
If you are having trouble controlling your blood sugar level after a meal look up the G.I. factor for the carbohydrates it contains. See if you can find substitutes with a lower G.I. factor amongst the list. Eating a meal with a lower G.I. factor can lower the blood sugar rise after the meal.
Although we haven’t mentioned them yet, don’t think that fatty foods are not important. They are, especially in people who are overweight. But fatty foods do not increase the sugar levels. Only carbohydrate foods do. However, being overweight and eating fatty foods prevents the body’s insulin from doing its job and indirectly causes the blood sugar levels to rise. So, eating hot chips or fried rice (mixtures of high G.I. carbohydrate and fat) causes double trouble. Not only does the high G.I. factor of potato and rice increase the blood sugar levels, but the extra fat will also eventually stop the body’s insulin from working properly and makes it less effective in clearing
the sugar from the blood. Persistently high blood sugar levels will ultimately damage the body.
The G.I. factor is especially important when carbohydrate is eaten by itself and not as part of a mixed meal. Carbohydrate tends to have a stronger effect on our blood sugar level when it is eaten alone. This is the case with between-meal snacks which most people with diabetes have to have. When choosing a between-meal snack, pick one with a low G.I. factor. For example, an apple with a G.I. factor of 36 is better than a slice of normal toast with a G.I. factor of around 70, and will result in less of a jump in the blood sugar level.
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FAT LOSS – BEHAVIOURAL INFLUENCES: OTHER APPROACHES
The late 1970s saw a shift towards portraying fat as a symbol in a person’s life, particularly in the Jives of women, and a re-examination of the psychodynamic aspects of being overfat. Susie Orbach saw fat as a kind of defensive psychological smoke screen, an unconscious rebellion for a woman against her sense of powerlessness in society. Compulsive eating, then, not only serves the deeper purpose of maintaining the distance between her real self and the rest of the world, but also acts to ‘blot out’ unacceptable feelings and thoughts. The problems of fatness become a reflection of a woman’s cultural position of inferiority; her compulsion to control her eating as a displacement of her inability to deal with other more profound aspects of her life. This theme was then taken up and expanded by Naomi Wolfe who sees the apparent epidemic in eating disorders as symbolic of society’s need to keep increasingly educated young women in a state of semi-starvation, rendering them ‘no trouble’.
Obviously this approach requires a different response to the behavioural strategies discussed above; if eating problems are caused by an existential and societal inequality, addressing the issue of powerlessness becomes the theme of both group and individual therapy. However, it is unclear from the feminist perspective how to account for the large numbers of men who acquire excessive fat. Presumably it is not for the same reasons of frustration and powerlessness, nor that they need to be assisted to come to terms with their ‘real’ selves. Perhaps males more easily tall into the trap of the ‘unconscious’ habits which more readily respond to the behaviour modification approaches. It seems highly likely that strategies need to be tailored to suit the individual.
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THE ROLE OF FAT IN ENERGY BALANCE: DE NOVO LIPOGENESIS
The lipogenic enzymes needed to make new fat are present in humans but in far smaller concentrations than in other animals. The rate of de novo lipogenesis in the liver can be estimated in normal humans and has been uniformly found in the order of only a few grams per day. In other words, even on a high-carbohydrate, low-fat diet, the body would not be expected to turn more than a few grams of the excess carbohydrate into fat.
While the liver may synthesise a small amount of fat from non-fat precursors, other tissues, such as skeletal muscle, may simultaneously be burning fat for fuel. Therefore, net whole body fat synthesis will only be present if the former is greater than the latter, which is rarely the case. Examples of conditions which result in net lipogenesis are forced overfeeding of carbohydrate (i.e. up to 5000kcal of carbohydrate per day in the resting state), some disease states such as cirrhosis or HTV infection, states of malnutrition, direct infusions of simple sugars intravenously (such as during intravenous nutrition) or into the abdominal cavity (such as during peritoneal dialysis). These can swamp the body’s ability to use glucose as an energy fuel or store it as glycogen, and under these conditions, some of the glucose is forced to convert into fat. However, this state is very difficult to achieve by eating or drinking the carbohydrate, even in the form of simple sugars.
Clearly, net de novo lipogenesis requires forced overfeeding of carbohydrate and does not occur under the conditions of ad libitum (at liberty or free) eating in normal individuals. Excessive consumption of carbohydrate (to the level of 50 per cent more than normal), has been shown to lead to increased fat deposition if maintained over the long term (14 days or more), but the indications are that this is because of fat sparing through increased carbohydrate use as an energy substrate, rather than conversion of excess carbohydrate to fat.
Myth-information. Contrary to popular opinion, carbohydrate-rich foods are not as fattening as those high in fat. This is not only because carbohydrates (sugars) contain less energy, and require more energy for storage, but because carbohydrate is not converted to fat in humans under normal physiological conditions.
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BABY AND CHILDHOOD RESPIRATORY DISORDERS: PNEUMONIA
Pneumonia was once a serious disease in children, with a high mortality rate. It is still dangerous, but today, with a wide range of antibiotics available, the death rate has fallen precipitously and the results now are usually good.
But parents should never overlook the symptoms and should take immediate action if they occur. Pneumonia means the air-containing lung substance has become infected; and areas of lung tissue, normally spongy, become filled with fluid and discharge and may even become a solid mass. This reduces the area available for normal exchanges of oxygen and carbon dioxide. Unless relief is imminent, death may result either from suffocation or from the spread of the disease and toxic effects of the organisms involved.
Onset may be rapid, with a rising fever, chills in older children and probably bouts of shivers. Breathing becomes rapid. There may be a cough. Vomiting and diarrhoea may occur. There may be aches and pains and a stiff neck. In older children there may be severe pain present, particularly in the tummy region. Sometimes the sudden onset of symptoms, especially the fever, may lead to convulsions, which are very worrying to parents. There may be obvious breathing difficulty, and the child may grunt when breathing out. Nostrils may be dilated, cheeks flushed, lips possibly a bluish shade (indicating cyanosis).
Any infant or child with symptoms of this nature needs immediate expert medical care. Pneumonia may lead on from a simple upper respiratory tract infection, or it may come on suddenly with no relationship to a previous infection. Never forget that normal respiration is essential to good health and if it is in any way jeopardized, for whatever reason, medical help is vital.
Antibiotics have revolutionized treatment of serious lung infections and pneumonia. The sooner this is started the better. So our advice is prompt attention. See the doctor. Do not delay or waste time in trying self-medication. Time lost could spell disaster.
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BABY AND CHILDHOOD ILLNESSES: HEAD ROLLING, HEAD BANGING AND ROCKING
Towards the end of the first year many infants resort to strange habits, such as banging the head, rolling the head or rocking the head and body when lying in the cot. Often this is more common when they are tired and as they are about to fall asleep. Many finally drop off into slumber.
Some infants pull at their hair, others knock and bruise themselves, particularly their arms. It may be an indication of boredom, or relief from tension. It has been related to adults drumming a desk with their fingers, or tapping the floor with their toes, or making other rhythmical movements when under stress.
Some parents fear the child may be mentally defective, or that the child is masturbating.
Treatment
It is worth having the infant examined by the family doctor if fears are held for his mental state. If the child obviously relates well to others and is making satisfactory mental and physical progress for his age, mental disorders can usually be ruled out. Most cases tend to settle down. Simple methods to prevent the child from mechanically injuring himself are worthwhile, such as padding the sharp edges and corners of the cot. Sedative medication is often prescribed, but this gives only temporary respite and is virtually useless. Most cases settle down in due course as they become older, and the problem automatically vanishes.
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