https://www.sandiegohealthdirectory.com/kb en-us THERE is no question that diet plays a very important role in the development of cardiovascular diseases and some forms of cancer, especially of the gastrointestinal tract. One particular diet -- one high in saturated fat and cholesterol, and low in fiber -- consisting mainly of red meats such as pork, beef, non-skim dairy products, etc and eggs, has been branded as unhealthy. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=169 Thu, 03 Aug 2006 08:05:16 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=169 -- George Bernard Shaw

THERE is no question that diet plays a very important role in the development of cardiovascular diseases and some forms of cancer, especially of the gastrointestinal tract. One particular diet -- one high in saturated fat and cholesterol, and low in fiber -- consisting mainly of red meats such as pork, beef, non-skim dairy products, etc and eggs, has been branded as unhealthy. Voluminous clinical studies have shown beyond a reasonable doubt that excess serum cholesterol, specifically chronically elevated HDL (the bad cholesterol) and triglycerides, is the culprit in the more than half a million deaths from heart attack each year in the US alone. This translates to one person dying from a cardiovascular illness every 60 seconds. And this does not even include the mortality from cancer.

Cholesterol is a sterol, a complex alcohol constituent of animal fats and oils. If abnormally high in the blood stream, this substance forms plaques, which adhere to the inner wall of arteries causing hardening of the arteries and stenoses or blockages, many leading to heart attacks, strokes, or poor leg circulation.

Cholesterol, in normal levels, is essential to health. The good cholesterol is called High Density Lipoprotein (HDL), and the bad cholesterol is called the Low Density Lipoprotein (LDL). For better health, a person should have Total Cholesterol no higher than 150, HDL above 60, LDL below 100, and Triglyceride level below 150. To be accurate and significant, the cholesterol study should include these four, in a blood test called Lipid Profile.

While our liver produces cholesterol, the main source of cholesterol in our body and the blood is from the food we eat. Some of the food types that are high in cholesterol include egg yolk, pork, duck, chicken skin, lamb, beef and other red meats, butter, lard, and other non-skim dairy products.

The good fats come from fish and are called fish oil or Omega-3 fatty acids. These substances are a natural blood thinner that prevents blood clot formation and minimizes hardening of the arteries. Thus, eating fish daily reduces the risk of heart attack and stroke, even among those who are diabetics and hypertensives - those with high blood pressure, provided these conditions are treated and well-controlled.

Everything else being similar, diabetics and hypertensives respond better to treatment, have fewer complications from their illness, and have a better prognosis if their total cholesterol, HDL, LDL and triglycerides are normal, compared to those whose lipid profile is out of whack.

The proponents of the vegetarian diet argue that studies have shown that the longest-lived animals had low-calorie vegetarian diet, and that rats fed high protein, high fat diet had the shortest life span. The studies of Dr. Paul Dudley on the Hunzas of Pakistan, who have amazing longevity, showed that they subsist on spartan and vegetarian diet of nuts, grains, fruits, vegetables, and a little goat milk. Fresh and/or dried apricots are their staple food. The Hunzas' lifespan is 140 years. While the inference is clearly there, more extensive controlled clinical studies on human subjects are needed to find out with certainty if vegetarian diet, although already proven to be healthy, really improves longevity.

Vegetables and fruits have phytochemicals that are good for our body. Twenty-three epidemiological studies have shown that diet rich in grains and vegetables reduces the risk of colon cancer by 40 percent, and breast cancer by 25 percent. Some of the hundreds of phytochemicals in fruits and vegetables are: lycophene, ellagic acid, lutein, flavanoids, saponins, monoterpenes, phthalides, phenols, ajoene, cassaicin, coumestrol, genistein, sulforaphane, zeanthin.

Our mothers were right in cajoling us to eat vegetables and fruits while we were growing up. Too bad, most of us didn't listen. But since we are now wiser and know better, let's educate our own children and persuade them to eat more vegetables and fruits -- and less animal meat -- for better health. The incidence of cancers, heart and kidney diseases, diabetes, hypertension, and obesity among vegetarians is much lower than among meat-eaters.

Vegetarians come in three forms: (1) Lacto-ovo vegetarians, whose diet consists of vegetables, dairy products and eggs, no meat or flesh of any kind such as pork, beef, lamb, etc., poultry, fish and seafood; (2) Lacto-vegetarians who do not eat eggs, but eat vegetables, fruits and milk; and, (3) Vegans or pure vegetarians, who do not eat any food or food products of animal origin, including milk and eggs, and subsist on vegetables, grains, nuts and fruits only. Most vegans also do not buy or use animal products, such as those made of leather, fur, feather, ivory, etc., all of which involves the killing of animals.

The Reverend William Metcalfe of England, together with his friend, Sylvester Graham, a young Presbyterian minister and 40 other English church members, brought the vegetarian way of life to the United States in 1817.

For thousands of years, being a vegetarian was a part of socio-cultural-religious practice around the globe, most notably in the Far East. Many people around the world today choose to be vegetarians for health reasons.

If you are a vegetarian, you're in good company. Some of the famous vegetarians include Pythagoras, Socrates, Plato, Leonardo da Vinci, Buddha, Plutarch, John Milton, Sir Isaac Newton, Mahatma Gandhi, The Dalai Lama, Benjamin Franklin, Shakespeare, Vincent Van Gogh, Leo Tolstoy, Ralph Waldo Emerson, Voltaire, Albert Schweitzer, George Bernard Shaw, Albert Einstein, Winston Churchill, Jean Jacques Rousseau, Rabindranath Tagore, Mark Twain, Robert Browning, Linda and Paul McCartney, John Denver, Richard Gere, Kim Basinger, Steven Spielberg, Cameron Diaz, Josh Hartnett…etc.

Knowledge as recorded in the Bible about how the Essenes, the Nazoreans and Ebionites, lived suggests that Christ was probably a vegetarian. He was vehemently against animal sacrifices. Matthew and Peter were said to be vegetarians. The brother of Jesus, James the Just, the first head of the church in Jerusalem after the death of Christ, was raised as a vegetarian.

If Jesus' parents raised James as a vegetarian then it would be likely that Jesus was also raised as one. The early Christian fathers adhered to a meatless regime. Many early Christian groups supported the meatless way of life. In fact, the writings of the early Church indicate that meat-eating was not officially allowed until the 4th century, when the Emperor Constantine decreed that the practice of vegetarianism was heresy and punishable by death.

Was man supposed to be a plant-eater instead of a meat-eater? Yes, according to several investigations and books on the subject. A. D. Andrews, author of "Fit Food For Men," made an anatomical and structural comparison between herbivores (plant-eating animals) and carnivores (meat-eating animals), and came to the conclusion that man's teeth, salivary glands, quality of saliva, long intestinal tract, absence of claws, are all similar to those of herbivores, very much unlike those of carnivores. Thus, he argues that man is a natural herbivore, and must eat what herbivores eat: vegetables, fruits, nuts, grains, and not meat or flesh, in order to stay healthy. Staying away from what herbivores should eat, and eating a lot of red meat, is unhealthy and is the cause of most, if not all, of man's ailments, is also a well-respected argument in the scientific community.

The belief that vegetarians are weak and sickly is a myth. Elephants, bulls, cows, and some dinosaurs (plateosaurus, brachiosaurus, etc.) are a few of the strongest animals known to man -- all herbivores. Various studies comparing athletes who are carnivores and herbivores revealed astonishing findings: Vegetarian athletes fared 2 to 3 times better, with greater endurance and better recovery time, compared to their meat-eating counterparts in similar sport activities.

Vegetarians get their protein from soybeans, lentils, kidney beans, lima and pinto beans, black beans, chickpeas, black-eyed peas, peanuts, almonds, cashew, sunflower seeds, and other nuts, broccoli and other vegetables, wheat, grains, brown rice, potato, and eggs and dairy products. These sources easily meet the daily requirement of between 60-80 grams of protein, even for vegans. So, animal meat is not really essential for health and life.

A daily low-fat, low-cholesterol, high-fiber diet of fish and a lot of vegetables, fruits, nuts and grains, and brown rice instead of white, with occasional red meat, if desired, coupled with abstinence from tobacco, doing daily exercises, maintaining proper weight, drinking a glass or two of red wine with dinner, taking a daily multivitamin-mineral supplement, taking time off with friends and/or family for rest and relaxation on weekends, visiting the doctor for check-up as advised, and adequately treating any existing medical condition for example hypertension, diabetes, etc. is our prescription for health, peace, happiness, and better productivity. ]]> WELLNESS aficionados will probably appreciate this did-you-know list. It isn't true that a little knowledge is a dangerous thing. In this case, it can help improve your state of well-being. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=140 Tue, 25 Jul 2006 06:14:22 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=140
1. One cigarette can destroy 25-100 mg of Vitamin C.
2. Most store-bought milk with synthetic Vitamin D added can rob the body of magnesium.
3. Elderly people do not get enough Vitamin D due to lack of exposure to the sun.
4. Oral contraceptives interfere with the extraction of Vitamin C, B6, B12, and folic acid from most diets.
5. Children need more protein than adults - about 11/2-2 times more per pound of body weight, and babies require three times more.
6. Daily "happy hours" can rob the body of Vitamin C and B.
7. The immune system will be depressed from constant consumption of foods with monosodium glutamate or vetsin, artificial colors/flavors, preservatives and other additives.
8. Raw peanuts have enzyme inhibitors that make it difficult for the body to digest all kinds of protein.
9. Natural fat/saturated fat is better for the body than hydrogenated fat, which is found in low-fat butter substitutes like margarine. Hydrogenated oil is a trans fatty acid that has been linked to cancer.
10. Vitamin B1 can ease sea and air sickness.
11. Carpal tunnel syndrome and hormonal imbalance could indicate Vitamin B deficiency.
12. Magnesium is a muscle relaxant and is considered nature's equivalent of calcium channel blocker drugs.
13. The United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University says daily consumption of Vitamin C supplements have been found to reduce the risk of developing cataracts.
14. For more brainpower, 100 mg of the phospholipid supplement phosphatidyl serine (PS) daily is suggested. It can help those with normal age-related memory problems regain at least 12 years of brainpower.
15. Recent studies have shown that the mineral selenium may significantly slow the progression of the human immunodeficiency virus (HIV), which causes the acquired immune deficiency syndrome (AIDS).
16. Flavonoids found in red grapes can be 1,000 times more powerful than Vitamin E.
17. People who consume nuts five or more times a week have a lower risk of developing heart disease compared to those who eat nuts less than once a week.
18. Drinking soda and eating foods with sugar substitutes stimulate the body to consume more fat.
19. An onion a day keeps stomach cancer away. Onion's allylic sulfides anti-cancer compounds activate enzymes that neutralize cancer-causing substances.
20. Many people lose enzymes necessary to digest milk after the age of 12. This is why adults suffer from lactose intolerance, like having gas/indigestion, after drinking milk.
21. Taking Vitamin E supplements can lower the risk of heart disease.
22. The American Cancer Society says new studies reveal that the life expectancy of non-smokers can be longer by 18 years compared to smokers.
23. Boron can be a woman's best friend. The trace-mineral found in apples, grapes, raisins may retard bone loss in women after menopause. It also helps women on ERT (estrogen replacement therapy) by keeping estrogen in the blood longer.
24. The swallowing of toothpaste should be avoided, as there may be a connection between the oral hygiene product with its additives and bowel diseases.
25. Aspirin may triple the rate of the body's release of Vitamin C.

Practice calmness:

Walk with purpose but with calmness. Speak with passion but with peace. Act with energy but with serenity. These are the ways to manage the forces within you, using them not against but together with the flow of life.

Choose an affirmation each morning to start your day with inspiration not aggravation.

Breathe in a relaxed manner. Close your eyes and affirm: "I walk with the Spirit today." Visualize yourself bathed in brilliant white light.

Calming drink:

Take a hot or chilled cup of peppermint tea. For extra energy, add a slice of fresh ginger for that zing.]]> A healthy diet and lifestyle are key weapons in the fight to prevent cardiovascular disease-- the nation’s No. 1 killer--according to new American Heart Association diet and lifestyle recommendations published in Circulation: Journal of the American Heart Association. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=138 Mon, 24 Jul 2006 08:41:05 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=138
Intended for healthy Americans age 2 and older, the recommendations, which replace guidelines issued in 2000, now recommend:
1. Further reducing saturated and trans fatty acids in the diet.
2. Minimizing the intake of food and beverages with added sugars.
3. Emphasizing physical activity and weight control.
4. Eating a diet rich in vegetables, fruits and whole-grain foods.
5. Avoiding use of and exposure to tobacco products.
6. Achieving and maintaining healthy cholesterol, blood pressure and blood glucose levels.

"The previous recommendations stressed a healthy dietary pattern; the new ones broaden that concept to include the importance of a healthy lifestyle pattern. The two go together--they should be inseparable," said Alice Lichtenstein, D.Sc., chair of the American Heart Association’s Nutrition Committee and Gershoff professor of nutrition science and policy at the Friedman School of Nutrition Science and Policy, at Tufts University in Boston.

"The key message of the recommendations is to focus on long-term, permanent changes in how we eat and live. The best way to lower cardiovascular risk is to combine physical activity with heart-healthy eating habits, coupled with weight control and avoiding tobacco products," Lichtenstein said.

The association continues to emphasize achieving and maintaining a healthy body weight, but is putting more emphasis on balancing the number of calories consumed with the number of calories burned. More emphasis is put on food preparation methods that avoid adding saturated fat, sugar or salt and portion size control.

A panel of nutrition and cardiovascular disease experts for the new American Heart Association recommendations reviewed more than 90 scientific publications. Besides the goals and recommendations, the statement has new sections with practical information for consumers such as knowing your caloric needs, food preparation tips and some examples of dietary patterns consistent with the new recommendations.

As in the past, the recommendations also address special groups such as children, older adults, individuals with metabolic syndrome or chronic kidney disease and certain socioeconomic groups at high risk for cardiovascular disease (CVD).
Most importantly, these new recommendations address a key challenge faced by increasing numbers of Americans: maintaining a healthy dietary pattern while eating more foods prepared outside the home.

Environmental factors strongly influence how Americans eat and exercise. Accordingly, a new feature of the 2006 American Heart Association Diet and Lifestyle Recommendations is a list of ways that practitioners, restaurants, the food industry, schools and local governments can help the general public adopt these recommendations. Examples include displaying caloric content prominently on menus, reducing portion size, limiting trans fatty acids and using low-saturated-fatty-acid oils in food preparation.

Another major change in the dietary recommendations is a lower goal for saturated fat--from less than 10 percent to less than 7 percent--and establishing a goal for trans fatty acids of less than 1 percent of total calories.

"The point is not to calculate the amount of saturated and trans-fatty acids in the diet, but to choose foods that minimize your intake. For example, you can choose leaner cuts of meat and lower-fat dairy products, smaller serving sizes, avoid foods made with hydrogenated fat and include more fruits, vegetables, vegetarian options and fish in the diet," Lichtenstein said.
Saturated fatty acids occur naturally in foods from animals, such as meat and dairy products, and tropical oils such as coconut and palm oil.
Trans-fatty acids--which are now required to be shown on the Nutrition Facts panel of packaged foods--are commonly found in commercially baked and fried foods, such as crackers, French fries, cakes, pies, bread and cookies.

"Almost anyone can make changes in how they eat and move their bodies to bring themselves closer to the recommended goals. The changes can be small but need to be maintained. In no way are we saying people will have to give up all the things they enjoy; they just may have to make a few modifications in their current habits," Lichtenstein said.
"A good first step to improve your diet and lifestyle--start paying attention to portion size and liquid calories, such as those in soft drinks, fruit drinks, fruit juices and alcoholic beverages. The next step is to try to get at least 30 minutes of physical activity every day," Lichtenstein said. "It does not have to be done all at once--accumulating 30 minutes throughout the day is fine--and, of course, more is better. No one is too old or too out of shape to make small changes to increase physical activity."

The association urges industry to gradually reduce the salt and sugar content of processed foods and to increase the proportion of whole grains compared to white flour in baked goods, among other recommendations.

Recommendations-At-A-Glance.

Consume an overall healthy diet:

Balance calories consumed with calories burned to maintain a healthy body weight
1. Increase awareness of calorie content of foods for the portion sizes you normally eat.
2. Know how many calories you need a day.
3. Aim for at least 30 minutes of physical activity daily.

Consume a diet rich in fruits and vegetables:
1. Include a wide variety of fruits and vegetables in your diet daily.
2. Emphasize vegetables and fruits--not fruit juices--that are deeply colored (spinach, carrots, peaches and berries).
3. Prepare fruits and vegetables with little added saturated or trans fat, salt and sugar.

Choose whole-grain, high-fiber foods:
1. Consume 2 servings of fish, especially oily fish, at least twice a week.
2. Examples of fish relatively high in omega-3 fatty acids include salmon, trout and herring.
3. Children and pregnant women should follow FDA guidelines for avoiding mercury-contaminated fish. Fish with potential for the highest mercury contamination are shark, swordfish, king mackerel and tilefish.

Limit intake of saturated fat, trans fat and cholesterol:
1. Choose lean meats and vegetable alternatives.
2. Select fat-free (skim) and 1 percent fat dairy products.
3. Minimize intake of partially hydrogenated fats.

Minimize the intake of beverages and foods with added sugars:
1. Choose and prepare foods with little or no salt.
2. Consume no more than 2300 mg of sodium per day.
3. Middle-aged and older adults, African-Americans and those with high blood pressure should consume for no more than 1500 mg.

Consume alcohol in moderation:
1. Limit alcohol intake to one drink per day for women and two drinks per day for men.
2. One drink is equal to 12 ounces of beer, 4 ounces of wine, 1.5 ounces of 80-proof distilled spirits or 1 ounce of 100-proof spirits.

When eating out:
1. Be aware of portion size.
2. Select options that include vegetables and fruits.
3. Select foods prepared with little added saturated or trans fat, salt and sugar.
Dietary factors with unproven or uncertain effects on cardiovascular disease risk.

Antioxidant vitamin supplements:
1. Vitamin E and other antioxidant supplementation studies to lower coronary heart disease have not demonstrated a benefit.
2. Dietary antioxidant nutrients should be obtained from foods high in these compounds such as fruits, vegetables and vegetable oils.

Folate and B vitamin supplements:
1. Folate and B vitamin supplementation studies to lower coronary heart disease have not demonstrated a benefit.

Soy Protein:
1. Use soy protein to replace animal protein products high in saturated fatty acids.
2. Recent studies cannot confirm direct benefit of consuming soy on plasma cholesterol levels; however, there may be an indirect benefit if soy replaces foods high in saturated fats.

Other recommendations.

Fish and fish oil supplements:
1. Eat two servings of fish, preferably oily fish, twice a week.
2. Patients with documented coronary heart disease should consume 1 gram of EPA + DHA per day, preferably from oily fish.
3. EPA + DHA supplements could be considered in consultation with a physician.
4. For individuals with hypertriglyceridemia, 2-4 grams of EPA + DHA, provided under a physician’s care, are recommended.

Plant stanols/sterols:
1. These may be helpful for people with elevated low-density lipoprotein (LDL) cholesterol.
2. Maximal effects have been observed at intakes of 2 grams per day.
3. To sustain LDL reductions, individuals need to consume them daily.
4. Plant stanols/sterols are available in a wide variety of foods, drinks and soft gel capsules.]]> Currently, the typical American diet is low in fruits, vegetables, and whole grains, and high in saturated fat, salt, and sugar. As a result, more Americans than ever are overweight, obese, and at increased risk for chronic diseases such as heart disease, high blood pressure, diabetes, and certain cancers. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=88 Tue, 20 Jun 2006 03:16:31 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=88
Currently, the typical American diet is low in fruits, vegetables, and whole grains, and high in saturated fat, salt, and sugar. As a result, more Americans than ever are overweight, obese, and at increased risk for chronic diseases such as heart disease, high blood pressure, diabetes, and certain cancers.

Of course old habits are hard to break, and the notion of change can seem overwhelming. But it can be done with planning and a gradual approach, says Dee Sandquist, a spokeswoman for the American Dietetic Association (ADA) and manager of nutrition and diabetes at the Southwest Washington Medical Center in Vancouver, Wash.
"Some people can improve eating habits on their own, while others need a registered dietitian to guide them through the process," Sandquist says. You may need a dietitian if you are trying to lose weight or if you have a health condition such as osteoporosis, high blood pressure, high cholesterol, or diabetes.

Sandquist says that many people she counsels have been used to eating a certain way and never thought about what they were actually putting into their bodies. "Someone may tell me they drink six cans of regular soda every day," she says. "When they find out there are about nine teaspoons of sugar in one can, it puts things in perspective. Then I work with the person to cut back to three cans a day, then to two and so on, and to start replacing some of the soda with healthier options."

Others are eating a lot of food between mid-day and bedtime because they skip breakfast, Sandquist says. Another common scenario is when someone has grown up thinking that meat should be the focus of every meal. "We may start by having the person try eating two-thirds of the meat they would normally eat, and then decreasing the portion little by little," Sandquist says. Cutting portion size limits calories. So does eating lean cuts of meat and using lower-fat methods of preparation such as broiling.

Sandquist says that when people strive for more balance in their diets, they tend to enjoy mixing up their food choices. "A lot of times, they've been eating the same things over and over. So when they start trying new foods, they find out what they've been missing."
Barbara Schneeman, Ph.D., director of the Food and Drug Administration's Office of Nutritional Products, Labeling, and Dietary Supplements, encourages consumers to make smart food choices from every food group. "The Nutrition Facts label is an important tool that gives guidance for making these choices," she says. The label shows how high or low a food is in various nutrients.

Experts say that once you start using the label to compare products, you'll find there is flexibility in creating a balanced diet and enjoying a variety of foods in moderation. For example, you could eat a favorite food that's higher in fat for breakfast and have lower-fat foods for lunch and dinner. You could have a full-fat dip on a low-fat cracker. "What matters is how all the food works together," Sandquist says.

Older people are most likely to improve their eating habits, but nutrition is important for people of all ages, says Walter Willet, M.D., chairman of the nutrition department at the Harvard School of Public Health. "We know that when people have health problems or their friends become ill, these are strong motivators of change," says Willet. "The more serious the health condition, the more serious the change. We'd rather people made changes early and prevent health problems in the first place."

So what if you're feeling trapped by a diet full of fast-food burgers and cookies? You can work your way out slowly but surely. Here are tips to move your eating habits in the right direction.

Write down what you eat for a few days to get a good picture of what you're taking in, suggests Cindy Moore, director of nutrition therapy at the Cleveland Clinic Foundation. "By looking at what you eat and how much you're eating, you can figure out what adjustments you need to make," she says.

Sometimes she asks patients to write down what they are feeling. Were you nervous, happy, or sad when you ate five slices of pizza in one sitting? "The very nature of writing things down in a food diary can help patients make changes," Moore says. "Someone will tell me, ‘I didn't want to have to write that I ate nine cookies, so I ate two instead.'"

You don't have to go cold turkey. In the end, you want to achieve a long-term healthy lifestyle. Small changes over time are the most likely to stick. "If you want to eat more vegetables, then try to add one more serving by sneaking it in," Moore says. "Add bits of broccoli to something you already eat like pizza or soup. If you need more whole grains, add barley, whole wheat pasta, or brown rice to your soup."

When you think about what you need to get more of, the other things tend to fall into place, Moore says. "If you have some baby carrots with lunch or add a banana to your cereal in the morning, you're going to feel full longer." You won't need a food that's high in sugar or fat an hour later, she adds.

Also, look for healthier versions of what you like to eat. If you like luncheon meat sandwiches, try a reduced-fat version. If you like the convenience of frozen dinners, look for ones with lower sodium. If you love fast-food meals, try a salad as your side dish instead of french fries.

"Pick one or two changes to start with," Moore says. "Once the changes have become habits, which usually happens in about two to four weeks, then try adding one or two more. In six to 12 months, you'll find that you've made substantial changes."

To make smart food choices quickly and easily, compare the Nutrition Facts labels on products. Look at the percent Daily Value (%DV) column. The general rule of thumb is that 5 percent or less of the Daily Value is considered low and 20 percent or more is high.

Keep saturated fat, trans fat, cholesterol, and sodium low, while keeping fiber, potassium, iron, calcium, and vitamins A and C high. Be sure to look at the serving size and the number of servings per package. The serving size affects calories, amounts of each nutrient, and the percentage of Daily Value.

The %DV is based on a 2,000-calorie diet, but recommended calorie intake differs for individuals based on age, gender, and activity level. Some people need less than 2,000 calories a day. You can use the %DV as a frame of reference whether or not you consume more or less than 2,000 calories. The %DV makes it easy to compare the nutrients in each food product to see which ones are higher or lower. When comparing products, just make sure the serving sizes are similar, especially the weight (grams, milligrams, or ounces) of each product.

Understanding the serving size on the Nutrition Facts label is important for controlling portions, Moore says. "Someone may have a large bottled drink, assuming it's one serving," she says. "But if you look at the label, it's actually two servings. And if you consume two servings of a product, you have to multiply all the numbers by two." When the servings go up, so do the calories, fat, sugar, and salt.

Moore also suggests dishing out a smaller amount on your plate or using smaller plates. "If you put more food in front of you, you'll eat it because it's there," she says. According to the ADA, an average serving size of meat looks like a deck of cards. An average serving size of pasta or rice is about the size of a tennis ball. Here are some other ways to limit portions: Split a meal or dessert with a friend at a restaurant, get a doggie bag for half of your meal, get in the habit of having one helping, and ask for salad dressing, butter, and sauces on the side so you can control how much you use.

You want to stay within your daily calorie needs, especially if you're trying to lose weight, says Eric Hentges, Ph.D., director of the USDA Center for Nutrition Policy and Promotion. "But you also want to get the most nutrients out of the calories, which means picking nutritionally rich foods," he says. Children and adults should pay particular attention to getting adequate calcium, potassium, fiber, magnesium, and vitamins A, C, and E.

According to the Dietary Guidelines, there is room for what's known as a discretionary calorie allowance. This is for when people meet their recommended nutrient intake without using all their calories. Hentges compares the idea to a household budget. "You know you have to pay all the bills and then you can use the leftover money for other things," he says. "The discretionary calorie allowance gives you some flexibility to have foods and beverages with added fats and sugars, but you still want to make sure you're getting the nutrients you need."
For example, a 2,000-calorie diet has about 250 discretionary calories, according to the Dietary Guidelines.

Fat provides flavor and makes you feel full. It also provides energy, and essential fatty acids for healthy skin, and helps the body absorb the fat-soluble vitamins A, D, E, and K. But fat also has nine calories per gram, compared to four calories per gram in carbohydrates and protein. If you eat too much fat every day, you may get more calories than your body needs, and too many calories can contribute to weight gain.

Too much saturated fat, trans fat, and cholesterol in the diet increases the risk of unhealthy blood cholesterol levels, which may increase the risk of heart disease. "Consumers should lower all three, not just one or the other," says Schneeman. Saturated fat is found mainly in foods from animals. Major sources of saturated fats are cheese, beef, and milk. Trans fat results when manufacturers add hydrogen to vegetable oil to increase the food's shelf life and flavor. Trans fat can be found in vegetable shortenings, some margarines, crackers, cookies, and other snack foods. Cholesterol is a fat-like substance in foods from animal sources such as meat, poultry, egg yolks, milk, and milk products.

Most of your fats should come from polyunsaturated and monounsaturated fatty acids, such as those that occur in fish, nuts, soybean, corn, canola, olive, and other vegetable oils. This type of fat does not raise the risk of heart disease and may be beneficial when consumed in moderation.

When buying meat, poultry, milk, or milk products, choose versions that are lean, low-fat, or fat-free. Choose lean meats like chicken without the skin and lean beef or pork with the fat trimmed off.

If you frequently drink whole milk, switch to 1 percent milk or skim milk. Many people don't taste a difference. Some mix whole milk with lower-fat milk for a while so the taste buds can adjust. This doesn't mean you can never eat or drink the full-fat versions, Schneeman says. "That's where the discretionary calories come in."

Other tips to reduce saturated fat include cooking with non-stick sprays and using olive, safflower, or canola oils instead of lard or butter. Eat more fish, which is usually lower in saturated fat than meat. Bake, grill, and broil food instead of frying it because more fat is absorbed into the food when frying. You could also try more meatless entrees like veggie burgers and add flavor to food with low-fat beans instead of butter.

The Dietary Guidelines recommend two cups of fruit per day at the 2,000-calorie reference diet. Fruit intake and recommended amounts of other food groups vary at different calorie levels. An example of two cups of fruit includes: one small banana, one large orange, and one-fourth cup of dried apricots or peaches.

Eat a variety of fruits--whether fresh, frozen, canned, or dried--rather than fruit juice for most of your fruit choices. "The whole fruit has more fiber, it's more filling, and it's naturally sweet," says Marilyn Tanner, a pediatric dietitian at the Washington University School of Medicine in St. Louis. Still, some juices, such as orange and prune, are a good source of potassium.

Ways to incorporate fruit in your diet include adding it to your cereal, eating it as a snack with low-fat yogurt or a low-fat dip, or making a fruit smoothie for dessert by mixing low-fat milk with fresh or frozen fruit such as strawberries or peaches. Also, your family is more likely to eat fruit if you put it out on the kitchen table.

The Dietary Guidelines recommend two and one-half cups of vegetables per day if you eat 2,000 calories each day.

Tanner suggests adding vegetables to foods such as meatloaf, lasagna, omelettes, stir-fry dishes, and casseroles. Frozen chopped greens such as spinach, and peas, carrots, and corn are easy to add. Also, add dark leafy green lettuce to sandwiches. "Involve kids by letting them help pick vegetables in different colors when you're shopping," Tanner suggests. Get a variety of dark green vegetables such as broccoli, spinach, and greens; orange and deep yellow vegetables such as carrots, winter squash, and sweet potatoes; starchy vegetables like corn; legumes, such as dry beans, peas, chickpeas, pinto beans, kidney beans, and tofu; and other vegetables, such as tomatoes and onions.

"Look for ways to make it convenient," Tanner says. "You can buy salad in a bag. Or buy a vegetable tray from the grocery store and put it in the refrigerator. Everything's already cut up and you can just reach in and eat it throughout the week."

Like fruits and vegetables, whole grains are a good source of vitamins, minerals, and fiber. The Dietary Guidelines recommend at least three ounces of whole grains per day. One slice of bread, one cup of breakfast cereal, or one-half cup of cooked rice or pasta are each equivalent to about one ounce. Tanner suggests baked whole-grain corn tortilla chips or whole-grain cereal with low-fat milk as good snacks.

In general, at least half the grains you consume should come from whole grains. For many, but not all, whole grain products, the words "whole" or "whole grain" will appear before the grain ingredient's name. The whole grain must be the first ingredient listed in the ingredients list on the food package. The following are some whole grains: whole wheat, whole oats or oatmeal, whole-grain corn, popcorn, wild rice, brown rice, buckwheat, whole rye, bulgur or cracked wheat, whole-grain barley, and millet. Whole-grain foods cannot necessarily be identified by their color or by names such as brown bread, nine-grain bread, hearty grains bread, or mixed grain bread.

Lower Sodium and Increase Potassium.
Higher salt intake is linked to higher blood pressure, which can raise the risk of stroke, heart disease, and kidney disease. The Dietary Guidelines recommend that people consume less than 2,300 milligrams of sodium per day (approximately one teaspoon of salt). There are other recommendations for certain populations that tend to be more sensitive to salt. For example, people with high blood pressure, blacks, and middle-aged and older adults should consume no more than 1,500 milligrams of sodium each day.
Most of the sodium people eat comes from processed foods. Use the Nutrition Facts label on food products: 5%DV or less for sodium means the food is low in sodium and 20%DV or more means it's high. Compare similar products and choose the option with a lower amount of sodium. Most people won't notice a taste difference. Consistently consuming lower-salt products will help taste buds adapt, and you will enjoy these foods as much or more than higher-salt options.

Prepare foods with little salt. The DASH (Dietary Approaches to Stop Hypertension) eating plan from the National Heart, Lung, and Blood Institute recommends giving flavor to food with herbs, spices, lemon, lime, vinegar, and salt-free seasoning blends. Consult with your physician before using salt substitutes because their main ingredient, potassium chloride, can be harmful to some people with certain medical conditions.
Also, increase potassium-rich foods such as sweet potatoes, orange juice, bananas, spinach, winter squash, cantaloupe, and tomato puree. Potassium counteracts some of sodium's effect on blood pressure.

The Dietary Guidelines recommend choosing and preparing food and beverages with little added sugars. Added sugars are sugars and syrups added to foods and beverages in processing or preparation, not the naturally occurring sugars in fruits or milk. Major sources of added sugars in the American diet include regular soft drinks, candy, cake, cookies, pies, and fruit drinks. In the ingredients list on food products, sugar may be listed as brown sugar, corn syrup, glucose, sucrose, honey, or molasses. Be sure to check the sugar in low-fat and fat-free products, which sometimes contain a lot of sugar, Tanner says.

Instead of drinking regular soda and sugary fruit drinks, try diet soda, low-fat or fat-free milk, water, flavored water, or 100 percent fruit juice.

For snacks and desserts, try fruit. "People are often pleasantly surprised that fruit is great for satisfying a sweet tooth," Tanner says. "And if ice cream is calling your name, don't have it in the freezer. Make it harder to get by having to go out for it. Then it can be an occasional treat."
Smart Snacks
Unsalted pretzels
Applesauce
Low-fat yogurt with fruit
Unbuttered and unsalted popcorn
Broccoli, carrots, or cherry tomatoes with dip or low-fat yogurt
Grapes
Apple slices with peanut butter
Raisins
Nuts
Graham crackers
Gingersnap cookies
Low- or reduced-fat string cheese
Baked whole-grain tortilla chips with salsa
Whole-grain cereal with low-fat milk

The 2005 Dietary Guidelines recommend finding your balance between food and physical activity. Consuming more calories than you expend leads to weight gain. More than half of all Americans don't get the recommended amount of physical activity. To reduce the risk of chronic disease in adulthood, engage in at least 30 minutes of moderate activity a day on most days of the week. Children and adolescents should engage in at least 60 minutes a day on most, and preferably all, days of the week.

To manage body weight and prevent gradual weight gain, people should exercise about 60 minutes at a moderate to vigorous intensity on most days of the week, while not exceeding recommendations for caloric intake. Sixty to 90 minutes may be needed to maintain weight loss.

The more vigorous the activity and the longer the duration, the more health benefits you'll get. But every little bit counts. Here are some examples of easy ways to work exercise into your day:

Take a 10-minute walk after breakfast, lunch, and dinner to reach the goal of 30 minutes per day.
Park your car in the farthest spot when you run errands.
Take a family walk after dinner.
Walk your dog.
Do yard work.
Wash your car by hand.
Pace the sidelines at kids' athletic games.
Ask a friend to exercise with you.
Run around and play with your children for 30 minutes a day.
Walk briskly at the mall.
Take the stairs instead of the elevator. ]]> When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion. Occasional heartburn is common but does not necessarily mean one has GERD. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=81 Mon, 19 Jun 2006 06:48:18 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=81
When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion. Occasional heartburn is common but does not necessarily mean one has GERD. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems.
Anyone, including infants, children, and pregnant women, can have GERD.

What are the symptoms of GERD?
The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning, or trouble swallowing. You may feel like you have food stuck in your throat or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

GERD in Children
Studies* show that GERD is common and may be overlooked in infants and children. It can cause repeated vomiting, coughing, and other respiratory problems. Children's immature digestive systems are usually to blame, and most infants grow out of GERD by the time they are 1 year old. Still, you should talk to your child's doctor if the problem occurs regularly and causes discomfort. Your doctor may recommend simple strategies for avoiding reflux, like burping the infant several times during feeding or keeping the infant in an upright position for 30 minutes after feeding.
If your child is older, the doctor may recommend avoiding
1. Sodas that contain caffeine
2. Chocolate and peppermint
3. Spicy foods like pizza
4. Acidic foods like oranges and tomatoes
5. Fried and fatty foods

Avoiding food 2 to 3 hours before bed may also help. The doctor may recommend that the child sleep with head raised. If these changes do not work, the doctor may prescribe medicine for your child. In rare cases, a child may need surgery.

What causes GERD?
No one knows why people get GERD. A Hiatal hernia may contribute. A Hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the LES keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up. In this way, a hiatal hernia can cause reflux. A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one.
Other factors that may contribute to GERD include
1. Alcohol use
2. Overweight
3.pregnancy
4. Smoking

Also, certain foods can be associated with reflux events, including
citrus fruits
1. Chocolate
2. Drinks with caffeine
3. Fatty and fried foods
4. Garlic and onions
5. Mint flavorings
6. Spicy foods
7. Tomato-based foods, like spaghetti sauce, chili, and pizza

How is GERD treated?
If you have had heartburn or any of the other symptoms for a while, you should see your doctor. You may want to visit an internist, a doctor who specializes in internal medicine, or a gastroenterologist, a doctor who treats diseases of the stomach and intestines. Depending on how severe your GERD is, treatment may involve one or more of the following lifestyle changes and medications or surgery.
1. Lifestyle Changes
2. If you smoke, stop.
3. Do not drink alcohol.
4. Lose weight if needed.
5. Eat small meals.
6. Wear loose-fitting clothes.
7. Avoid lying down for 3 hours after a meal.
8. Raise the head of your bed 6 to 8 inches by putting blocks of wood under the bedposts—just using extra pillows will not help.

Medications
Your doctor may recommend over-the-counter antacids, which you can buy without a prescription, or medications that stop acid production or help the muscles that empty your stomach.

Antacids, such as Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and Riopan, are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Many brands on the market use different combinations of three basic salts—magnesium, calcium, and aluminum—with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, have side effects. Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects.
Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can also be a supplemental source of calcium. They can cause constipation as well.

Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.

H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have GERD symptoms. Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor.

Proton pump inhibitors include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are all available by prescription. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms in almost everyone who has GERD.

Another group of drugs, prokinetics, helps strengthen the sphincter and makes the stomach empty faster. This group includes bethanechol (Urecholine) and metoclopramide (Reglan). Metoclopramide also improves muscle action in the digestive tract, but these drugs have frequent side effects that limit their usefulness.

Because drugs work in different ways, combinations of drugs may help control symptoms. People who get heartburn after eating may take both antacids and H2 blockers. The antacids work first to neutralize the acid in the stomach, while the H2 blockers act on acid production. By the time the antacid stops working, the H2 blocker will have stopped acid production. Your doctor is the best source of information on how to use medications for GERD.

What if symptoms persist?
If your heartburn does not improve with lifestyle changes or drugs, you may need additional tests.

A barium swallow radiograph uses X rays to help spot abnormalities such as a hiatal hernia and severe inflammation of the esophagus. With this test, you drink a solution and then x rays are taken. Mild irritation will not appear on this test, although narrowing of the esophagus—called stricture—ulcers, hiatal hernia, and other problems will.

Upper endoscopy is more accurate than a barium swallow radiograph and may be performed in a hospital or a doctor's office. The doctor will spray your throat to numb it and slide down a thin, flexible plastic tube called an endoscope. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities. If you have had moderate to severe symptoms and this procedure reveals injury to the esophagus, usually no other tests are needed to confirm GERD.

The doctor may use tiny tweezers (forceps) in the endoscope to remove a small piece of tissue for biopsy. A biopsy viewed under a microscope can reveal damage caused by acid reflux and rule out other problems if no infecting organisms or abnormal growths are found.

In an ambulatory pH monitoring examination, the doctor puts a tiny tube into the esophagus that will stay there for 24 hours. While you go about your normal activities, it measures when and how much acid comes up into your esophagus. This test is useful in people with GERD symptoms but no esophageal damage. The procedure is also helpful in detecting whether respiratory symptoms, including wheezing and coughing, are triggered by reflux.

Surgery
Surgery is an option when medicine and lifestyle changes do not work. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort.

Fundoplication, usually a specific variation called Nissen fundoplication, is the standard surgical treatment for GERD. The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia.

This fundoplication procedure may be done using a laparoscope and requires only tiny incisions in the abdomen. To perform the fundoplication, surgeons use small instruments that hold a tiny camera. Laparoscopic fundoplication has been used safely and effectively in people of all ages, even babies. When performed by experienced surgeons, the procedure is reported to be as good as standard fundoplication. Furthermore, people can leave the hospital in 1 to 3 days and return to work in 2 to 3 weeks.

In 2000, the U.S. Food and Drug Administration (FDA) approved two endoscopic devices to treat chronic heartburn. The Bard EndoCinch system puts stitches in the LES to create little pleats that help strengthen the muscle. The Stretta system uses electrodes to create tiny cuts on the LES. When the cuts heal, the scar tissue helps toughen the muscle. The long-term effects of these two procedures are unknown.
Implant

Recently the FDA approved an implant that may help people with GERD who wish to avoid surgery. Enteryx is a solution that becomes spongy and reinforces the LES to keep stomach acid from flowing into the esophagus. It is injected during endoscopy. The implant is approved for people who have GERD and who require and respond to proton pump inhibitors. The long-term effects of the implant are unknown.

What are the long-term complications of GERD?
Sometimes GERD can cause serious complications. Inflammation of the esophagus from stomach acid causes bleeding or ulcers. In addition, scars from tissue damage can narrow the esophagus and make swallowing difficult. Some people develop Barrett's esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer.
Also, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERD.

For information about Barrett's esophagus, please see the Barrett's Esophagus fact sheet from the National Institute of Diabetes and Digestive and Kidney Diseases.

Points to Remember
Heartburn, also called acid indigestion, is the most common symptom of GERD. Anyone experiencing heartburn twice a week or more may have GERD.

You can have GERD without having heartburn. Your symptoms could be excessive clearing of the throat, problems swallowing, the feeling that food is stuck in your throat, burning in the mouth, or pain in the chest.

In infants and children, GERD may cause repeated vomiting, coughing, and other respiratory problems. Most babies grow out of GERD by their first birthday.
If you have been using antacids for more than 2 weeks, it is time to see a doctor. Most doctors can treat GERD. Or you may want to visit an internist—a doctor who specializes in internal medicine—or a gastroenterologist—a doctor who treats diseases of the stomach and intestines.

Doctors usually recommend lifestyle and dietary changes to relieve heartburn. Many people with GERD also need medication. Surgery may be an option.
Hope Through Research

No one knows why some people who have heartburn develop GERD. Several factors may be involved, and research is under way on many levels. Risk factors—what makes some people get GERD but not others—are being explored, as is GERD's role in other conditions such as asthma and bronchitis.

The role of hiatal hernia in GERD continues to be debated and explored. It is a complex topic because some people have a hiatal hernia without having reflux, while others have reflux without having a hernia.

Much research is needed into the role of the bacterium Helicobacter pylori. Our ability to eliminate H. pylori has been responsible for reduced rates of peptic ulcer disease and some gastric cancers. At the same time, GERD, Barrett's esophagus, and cancers of the esophagus have increased. Researchers wonder whether having H. pylori helps prevent GERD and other diseases. Future treatment will be greatly affected by the results of this research. ]]>