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.
*50\186\4*
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.
*74\87\2*
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.
*24\87\2*
OATS
(Avena sativa)
This grain, common in the Western diet, has become fashionable in recent years for its bran’s ability to control cholestrol levels in the blood. It is the inositol in oat bran, a B-complex vitamin, which helps to increase the blood’s ratio of high density lipoproteins to the cholestrol-rich low density lipoproteins. While the miraculous properties of oat bran may have been exaggerated, a deficiency of inositol can certainly lead to a significant increase in blood cholestrol levels.
As a source of fibre, oat bran is considered superior to wheat bran as it will not scour the bowel. In cases of severe bowel irritation however, laxatives such as psyllium should be used instead.
Oats in their wholegrain and rolled forms are an excellent source of protein, Vitamin B1, calcium, iron and silicon. The aforementioned inositol also aids the body’s absorption of zinc. A tea made of oat straw is sometimes recommended for chest and skin complaints. The skin toning properties of oats are widely recognised and oatmeal is an ingredient in many natural facial scrubs and face packs.
*24\69\2*
COMMON CAUSES OF ANXIETY: SEXUAL CAUSES OF TENSION
Sexual Causes of Tension-At the present time there is a tendency to lay great emphasis on sex, and the tensions of both young and old are often ascribed to some disharmony in their sex life without due consideration of other factors. This line of approach is particularly common with the amateur psychologist. In evaluating the situation it is well for us to realize that sexual conflicts are in fact a very important cause of anxiety, but that conflicts in other areas are also important, and that anxiety often results from a summation of stresses arising from various problems.
There is another factor which makes it difficult to assess the significance of sexual troubles as a cause of anxiety. People have a tendency to give socially acceptable explanations for things. A man is working hard at his office; there are many difficult problems, and he has to work late at night. He will readily tell you this is the cause of his anxiety, and in a way it is true enough; but he does not readily discuss the tension he feels as a result of his being involved with his secretary. The patient often gives these false explanations quite knowingly for the simple reason that he is too ashamed to admit the real cause to the doctor. In other cases, the patient is too ashamed to admit the true cause even to himself. In these circumstances he believes that he is speaking the truth when he gives the socially acceptable reason as the cause of his trouble.
*27\57\2*
PAIN IN THE NECK-HELPING YOURSELF WHEN YOU’RE ALONE
Now although massage usually works best when you’re being soothed by the hands of someone you know and trust — and even better when it’s someone you love—it’s perfectly possible to give yourself fingertip massage of the forehead, if you’re all on your own when a headache begins. If you sit in your most relaxed position, you’ll probably find that you can soothe quite a lot of pain away. It’s also possible to massage your own scalp. This usually works best if you make the skin move under your fingers.
Stiff necks and aches at the nape of the neck are rather more of a problem, of course, because you can’t massage your own spine. If your shoulders are stiff and aching, you can ease a lot of tension by rotating them gently round and round. Imagine you have a pencil stitched on to your shirt so that it lies neatly along the shoulder seam, and you’re using it to draw a circle in the air. Rotate one shoulder and then the other. Make sure your shoulders have dropped into their most relaxed position.
Pain at the nape of your neck can be eased in a similar way by rotating your head, rolling it slowly and gently round and round and at the same time massaging the top of your spine with a gentle pinching movement between thumb and fingers. Start at the nape of your neck and gradually move higher and higher up your spine until you reach your hairline. Both these exercises should help you to be aware of the places where your spine and shoulders are too tense for comfort, and help you to relax them into an easier position.
*21\177\2*
THE BASIC CONCEPTS OF ALLERGIES: WAXES
Although many shoppers are unaware of the fact, certain fruits and vegetables are sold with a coating of paraffin wax. The wax on parsnips and rutabagas is so thick that you can scrape it off with your fingernail. But other so-called fresh produce, such as cucumbers, green peppers, and apples, are often sprayed with a light coating of paraffin to improve their appearance and shelf life. Not surprisingly, this petroleum-derived wax can contribute to the health problems of susceptible persons.
Some people think it is safe to eat such foods if they simply peel the wax away. But wax particles stick to the cut surfaces of waxed fruits and vegetables. To prove this, you simply have to peel a parsnip or other heavily waxed vegetable and then dip it into boiling water. Wax droplets may rise to the surface of the water, despite the fact that you supposedly removed the wax through peeling.
Peeling a commercial cucumber or apple is more effective in removing the wax. But these produce may still contain other chemical residues that can cause problems.
*23\110\2*
DEHYDRATION IN CHILDREN
Dehydration is a serious loss of body fluids. It occurs when the body is losing more fluids than it is taking in. When an excessive amount of body fluid is lost, the body loses the water, minerals, and salts contained in the fluid. Proper amounts of water, minerals, and salts are essential to health and to life.
Several conditions may cause the body to lose an excessive amount of water, minerals, and salts. Diarrhea, vomiting, and excessive sweating are common causes of dehydration. Illnesses that cause excessive breathing (such as asthma) may cause the child to lose water vapor from the lungs. Illnesses that cause excessive urination (such as diabetes) may also cause dehydration.
The smaller the child, the more quickly dehydration can develop. In young infants, dehydration occurs as rapidly as 12 to 24 hours after the start of any cause of dehydration (such as diarrhea or vomiting). A child who is not losing extra fluids will rarely become dehydrated simply by taking in fewer liquids. Except in young infants and in children with diabetes, the kidneys can compensate for a smaller intake of liquids. However, a small intake of liquids in a child who is also losing fluids causes dehydration to occur even more rapidly.
Signs and symptoms
Except in a child with diabetes, a sign of dehydration is a smaller output of urine. A young child who goes six to eight hours without urinating, or an older child who does not urinate for ten to 12 hours, may be dehydrated. Other signs of dehydration include sunken eyes; drowsiness; rapid or slow breathing; and depression (sinking in) of the soft spot in an infant’s skull. The membranes inside the mouth may feel dry when touched by a finger. The skin may feel less flexible than usual when pinched between the thumb and forefinger.
Home cake
If a child shows any symptoms of dehydration, call your doctor. If the child is vomiting, stop the vomiting first. With any condition that causes fluid loss (including prolonged high fever), you should encourage your child to drink extra fluids. The best liquids to give a child with increased fluid loss are commercial fluids that contain proper salts and sugar. Other good liquids are gelatin desserts (liquid or gelled); weak tea with sugar; ginger ale, colas, and other carbonated drinks. Plain water is less helpful. Milk products should be avoided.
Precautions
• Do not give undiluted skim milk and boiled whole milk to a child who is losing fluids. Their salt and mineral content is too great for the child to tolerate.
• If symptoms of dehydration develop, contact your doctor. The younger the child, the more urgent the situation. Diarrhea in infants can be very serious.
• The amount of urine output cannot help detect dehydration in a diabetic child.
Medical treatment
Your doctor will diagnose and treat the condition that is causing dehydration. Your child may be admitted to a hospital to be given intravenous fluids and salts. The child may be tested for the amounts of salts and minerals in the body.
*48/84/5*
AGE EXTENDERS: HEALING HERBS
Protecting against aging. Sometimes it seems like everybody’s anti this or anti that. Well, that holds true for some herbal remedies, too. Grape seed, for example, is antioxidant. Oxidation is basically the body’s equivalent of rust, at the cellular level. It tears down, weakens, and ultimately kills cells that make up our skin and tissues-a process associated with aging and degenerative diseases. Antioxidants, which are found mainly in fruits and vegetables, help counter the cellular wear and tear. How much grape seed should you use? Follow the instructions on the label, says Dr. Tyler.
Ending constipation, reducing cholesterol, guarding against colon cancer. All you have to do is drink slime. That’s right. Nice, slimy psyllium in water. Take it flavored or unflavored. Take it as raw husks (which you’ll find at the health food store) or as ground-up seeds like those contained in the commercial preparation called Metamucil (which you’ll find in the supermarket, along with less-expensive generic versions). Use psyllium daily, says Dr. Tyler, with water and other liquids. Lots of liquid-that’s key. This bulking fiber, used daily or more often, gently pushes wastes through the intestinal tract. “It acts like a giant sponge going through the gut, swabbing it out. And it tends to remove carcinogens before they can have much effect,” Dr. Tyler says. As an extra added bonus, psyllium can cut cholesterol, too. For regularity, though, you have to use it, um, regularly. Follow the instructions on the label.
Feeling mote vital. Studies show that taking ginseng, along with a multivitamin, lifts spirits and, in general, makes a man feel better, Dr. Tyler says. It’s a tonic. Of the many products on the market, the concentration of ginsenosides may vary. Buy a standardized extract that contains 4 percent of the active ingredient ginsenosides, and follow the dosage on the label, he says.
An herb called Siberian ginseng, which really is not a member of the true ginseng family, works similarly, says Terry Willard, Ph.D., herbalist. Dr. Willard suggests taking from 500 to 1,000 milligrams of Siberian ginseng twice daily.
*54/36/5*
BEFORE OPERATION ON BREAST CANCER: PREPARATION FOR ANESTHESIA
You will be told not to have anything to eat or drink for at least 6 hours before your operation (‘nil by mouth’). The reason for this is that any food or drink left in your stomach when you are anaesthetized could cause you to be sick and to choke on your vomit.
While you are still on the ward, you will be given your ‘pre-med/, if you are to have one, and any medicines you normally take. You will then be taken to the operating theatre, probably on a hospital trolley. You may go first into the anesthetic room or straight into the operating theatre to be given your anesthetic.
The anesthetist, or an assistant, will ask you several questions to confirm your identity and make sure that you are the right person in the right place. Your identity bands will also be checked. Many people have many types of operations each day in a hospital, and these checks, which may be repeated, are essential to make sure no mistakes are made.
The anesthetist will then fit various monitoring devices to watch over you while you are asleep. A probe may be attached to your finger to measure the amount of oxygen in your blood; some sticky pads may be put on your chest so that your heart beat can be recorded on an electrocardiograph; and a cuff may be put around your arm to measure your blood pressure. All these monitoring devices enable the anesthetist to make sure that the anesthetic remains effective and that you remain well during surgery.
A plastic cannula will be put into a vein in the back of your hand, and any drugs will be introduced into your body through this.
Once the anesthetist is happy with the readings from the monitors, your anesthesia can start.
*34/39/5*